Please place a check mark in the box next to the scholarships you are applying for. Please only submit one application form.

□ Teen Rockland Israel Program Scholarship (T.R.I.P.S.) 

The scholarship is available for teenagers living in Rockland County who wish to study in Israel either during high school or college. Scholarship amount varies based on funds available, number of students who qualify and need.

□ Dr. Edward Fisher Youth Israel Scholarship Fund

The fund will grant one $500 scholarship annually for a student attending an Israel summer program. The applicant must be a Jewish student in grades 9-12, living in Rockland County, who demonstrates leadership qualities and community involvement.  This must be the applicant's first organized trip to Israel and it must be an educational program. The student must agree to share his/her experience at community-wide events during the year following their trip.
□ Dr. Kerry Weinberg Youth Israel Scholarship Fund
This fund will grant one scholarship to a student participating in a University based Israel program.  The applicant must be a Jewish student living in Rockland County, who attends either public or private school in grade12. The student must agree to share his/her experience at community-wide events during the year following their trip.

T . R . I . P . S .

Teen Rockland Israel Program Scholarship Fund

Israel Trip: Programs for 5767-5768

From: Center for Jewish Education of Rockland

Re: Applying for a scholarship? Please read the following:

· Are you a resident of Rockland County?

· Which trip are you applying for?

Program	Application due date
Summer Session 5767	3:30 p.m. Thursday, March 1, 2007
Year Long 5768	5 p.m. Friday, May 4, 2007
Fall Semester 5768	5 p.m. Friday, May 4, 2007
Winter Session 5768	5 p.m. Monday, October 1, 2007
Spring Semester 5768	5 p.m. Friday, November 30, 2007

· Fill out enclosed application & submit with attached recent photograph by appropriate deadline.

· Please send in a letter of recommendation by appropriate deadline.

· Please send in written verification of acceptance to an Israel program by appropriate deadline.

· Look for other funding sources!

Remit all materials to:

Center for Jewish Education of Rockland
900 Route 45 - Suite 1
New City, NY 10956-1140
Or fax to (845) 362-4282 Questions: (845) 362-4200 x130

Date Received: Please attach a recent

photograph here.

T . R . I . P . S .

Teen Rockland Israel Program Scholarship

The JEWISH FEDERATION OF ROCKLAND

FINANCIAL AWARD APPLICATION

Please type or print clearly. Every question must be answered.

Application to be filled out by student and parents, unless student is self – supporting.

Date ___________________

1. Student’s Name _______________________________________________________

(last) (first) (middle)

2. Address______________________________________________________________

(street) (city) (state) (zip code)

3. Telephone ( ) ____________ E – mail ____________________________

4. Birthdate ______________ Entering Grade in September ____________

5. Name of High School/University __________________________________________

6. Father’s full name _____________________________________________________

7. Father’s occupation ____________________________________________________

8. Father’s business address ________________________________________________

9. Father’s business phone _________________________________________________

10. Mother’s full name ____________________________________________________

11. Mother’s occupation ___________________________________________________

12. Mother’s business address ______________________________________________

13. Mother’s business phone ________________________________________________

14. Marital status of parents _______________Number of children in family _________

15. Legal guardian (if neither of the above) ____________________________________

16. Address of guardian ___________________________________________________

17. Home phone of guardian ___________ Business phone of guardian _____________

18. How did you hear of our scholarship program? ______________________________

19. Are you a member of a synagogue? _______ If so, which one? _________________

20. Have you discussed financial aid with your Rabbi or congregation? ______________

21. Where else have you applied for financial help? _____________________________

22. What amount of financial help did you receive or hope to receive from sources other

than Federation? ______________

23. Family’s annual income (or student’s income if self – supporting) _______________

24. Does student work? ____If so, where, & how many hours per week? ____________

___________________________________________________________________

25. List any educational expenses or extenuating circumstances including school tuition,

child care, unemployment etc. (If more space is needed, please add additional sheet)

_____________________________________________________________________

_____________________________________________________________________

26. How much can the family afford to pay toward the cost of the trip? ______________

27. Please check any of the following you have attended, participated in or completed:

Type of Involvement Name of School/Org. No. of Years

____Hebrew School _________________ ___________

____Jewish Camp _________________ ___________

____Jewish Day School _________________ ___________

____Bar/Bat Mitzvah _________________ ___________

____Jewish Youth Group _________________ ___________

____Hebrew High School _________________ ___________

____Confirmation _________________ ___________

____Other _________________ ___________

28. Have you ever been to Israel before? _________Yes __________ No

29. If yes, when? ______________ What was the nature of the trip? ________________

30. Briefly explain why you want to go to Israel and what you hope to gain from the experience. (If more space is needed, please add additional sheet)

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

31. To which program have you applied? ______________________________________

32. What is the name of the program contact person? ____________________________

33. What is the address of the program in the U.S.? ______________________________

________________________________________________________________________

34. What is the cost of the program? _________________________________________

35. What are the dates of the program? _______________________________________

36. Would you be willing to discuss your experience with others in the community?______________________________________________________________

35. Does your family contribute to the Jewish Federation of Rockland County? _______

Applicants must also submit the following:

· For High School Applicants: One letter of recommendation from a Rabbi, guidance

· counselor, school principal, teacher or agency executive who has known you for two years or longer. (Recommendation form is enclosed).

· For College Age Applicants: One letter of recommendation from a Rabbi, professor,

· employer, or agency executive who has known you for two years or longer. (Recommendation form is enclosed).

· Verification of acceptance to an accredited Israel program.

· Recent photograph attached to this application.

PLEASE REVIEW THIS APPLICATION TO BE CERTAIN THAT ALL ANSWERS ARE ACCURATE AND COMPLETE. ALL INFORMATION IS STRICTLY CONFIDENTIAL.

ONLY FULLY COMPLETED APPLICATION WILL BE ACCEPTED.

NO APPLICATION ACCEPTED AFTER DUE DATE AND TIME.

I certify that all statements in this application are accurate to the best of my knowledge.

Date ____________ __________________________________________

Signature of applicant

Date ____________ __________________________________________

Signature of parent or guardian

Please return to:

Center for Jewish Education of the Jewish Federation of Rockland

900 Route 45 – Suite 1

New City, NY 10956-1140

Attn: Laurie Hoffman

T.R.I.P.S. Teen Rockland Israel Program Scholarship

FINANCIAL AWARD LETTER OF RECOMMENDATION

Letter of recommendation from a Rabbi, professor, employer, or agency executive who has known the applicant for at least two years.

Name of Applicant _______________________________________________________

Your Name (please print)_____________________________Telephone _____________

Position _______________________________________________________________

School or Synagogue __________________________ Telephone ________________

What is your relationship to the applicant? ____________________________________

Please comment on the applicant’s leadership, maturity, and intellectual capacity.

Use additional sheets if necessary. Please type or print clearly. ____________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Signed by ______________________________________________________________

Please return to:

Program	Application due date
Summer Session 5767	3:30 p.m. Thursday, March 1, 2007
Year Long 5768	5 p.m. Friday, May 4, 2007
Fall Semester 5768	5 p.m. Friday, May 4, 2007
Winter Session 5768	5 p.m. Monday, October 1, 2007
Spring Semester 5768	5 p.m. Friday, November 30, 2007