Gan Israel Day Camps - Scholarship Fund

Scholarship- The Witover and TLC/Jay Jacobs Scholarship Fund
Request for Special Assistance – Summer 2025

(This application is confidential. It will be processed by the regional Camp Scholarship Fund Committee and will not be seen by your local Chabad staff. Applications should be filled out online or mailed to Camp Gan Israel, 65 Valleywood Rd. Commack, NY 11725. Monies are distributed on a first come-first serve merit basis, with a maximum of $500 per child for a full session. If granted, you will be notified that a check will be sent directly to the camp.)
Date

Month Day Year
Name and age of Child/ren* Child #1
Name and age of Child/ren* Child #2
Name and age of Child/ren* Child #3
Name and age of Child/ren* Child #4
Which CGI are you applying to?*
Would this be your first year at CGI?*

yesno
Did you recieve a scholarship last summer?*

yesno
How many weeks of camp are you applying for?
Parent Information
Full Name*
First Name Last Name

Address*

Phone Number

Area Code Phone Number
E-mail*
Please state clearly and in detail how much you are requesting from Camp Gan Israel Camp Fund*
How much is the total camp tuition for your child/ren?*
How much of that are you able to pay?*
Please detail the circumstances which require this assistance:*
Please submit a letter of referral by replying to this response email. These letters need to be from local professionals who are familiar with your family’s situation. Examples: Rabbi, principal, teacher, social service worker, etc. Submitting these letters, and this application, constitutes your permission for the administration of Camp Gan Israel Scholarship Committee to discuss your circumstances with the letter writer, or to call you as well. All information provided will remain strictly confidential.
Additional Comments:
Signature
Should be Empty:

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Scholarship- The Witover and TLC/Jay Jacobs Scholarship Fund