Israel Scholarship Application

Applications for 2025 experiences will be accepted on a rolling basis.
Applicants must complete section 1 of the application.
Applicants must submit a personal statement explaining the reasons they want to travel to Israel and what they hope to gain from the experience. This is a key component in the evaluation of the application.
A Rabbi or other Jewish community professional should submit a recommendation letter on behalf of the applicant to the Foundation. The letter should include the date that the meeting took place to discuss the trip. If assistance is needed in this area, please contact our office at 716-204-1133.
Applications must be submitted at least 45 days prior to the deadline given by your program.

Applicant Information
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Home Phone
Mobile Phone
Date of Birth*
MM slash DD slash YYYY
Email*

Parent 1
First Last
Occupation
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Mobile Phone
Email
Parent 2
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone
Mobile Phone
Email
Parents Marital Status*
Custodial Parent*
Siblings
Name Age Occupation
Other Members of Household
Name Age Occupation

Education
Enrollment status*
Enrollment Status*
Name of School*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Expected Graduation Date*
Year Month
Diploma or Degree Sought*
Future Education Goals*
Previous Schooling
College
Name Years Attended
High School
Name Years Attended
Other School
Name Years Attended

Employer Name	Position Held	Address (street, city, state, zip)	Supervisor	Dates Employed

Applicant Information

Name	Age	Occupation

Name	Age	Occupation

Name	Years Attended

Name	Years Attended