Rocker Family Scholarship Application

wibit Thank you for your interest in the Rocker Family Camp Scholarship Program. Please review the eligibility criteria and potential scholarship award amounts here before completing the application below. Applications will only be considered when complete, including tax documents. If your child(ren) or family does not meet the criteria but has an extenuating circumstance, we recommend calling us before completing the application; you’ll have the opportunity to share pertinent information in the application.

Please password protect your files before uploading them. You will be prompted to provide the password after you have submitted this application.

Our objective is to compassionately and fairly allocate limited funds to those with the greatest need who would otherwise not be able to attend camp. The Rocker Family Camp Scholarship Program is the final source of financial assistance for camp; before applying, applicants are required to submit scholarship requests to the camp and to their synagogue (if applicable), as well as to reach out to extended family and other community resources as available. The family is expected to make a contribution to the total cost of camp. You are required to submit this information, along with the first two pages of your most recent Federal tax return and any schedules filed, as part of your application.

For any questions or guidance on choosing a camp, contact Gerri Russo at 973-929-2972 or grusso@jfedgmw.org

Step 1 of 5

PERSONAL INFORMATION

* denotes required fields
Name of Parent/Guardian 1*

First Name of Parent / Guardian 1:

Last Name of Parent / Guardian 1:
Address of Parent/Guardian 1*

Address Line 2

City

State

ZIP Code
Cell phone # of Parent/Guardian 1:*
Email address of Parent/Guardian 1:*
Do you belong to a temple or synagogue? If Yes, indicate the name of the synagogue below
Name of synagogue
Name of Parent/Guardian 2

First Name of Parent / Guardian 2 (if applicable):

Last Name of Parent / Guardian 2 (if applicable):
Is this address the same as Parent/Guardian 1? (if applicable)
- Yes
- No
Address of Parent/Guardian 2

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Cell phone # of Parent/Guardian 2 (if applicable):
How did you hear about the Rocker Family Scholarship?
Number of children applying for a scholarship:*

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Rocker Family Scholarship Application

Financial Incentives

Step 1 of 5

PERSONAL INFORMATION

CAMPER DETAILS (for each child applying for scholarship)

Camper Details for Child 1:

Camp Financial Information for Child 1:

Camper Details for Child 2:

Camp Financial Information for Child 2:

Camper Details for Child 3:

Camp Financial Information for Child 3:

Camper Details for Child 4:

Camp Financial Information for Child 4:

Volunteering and Personal Statement:

Income Documents - See Important Requirements Below