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Application
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Note:  Please complete a separate application for each eligible camper child.
Note:  All fields marked with asterisk (*) are compulsory.

Name of Person Filling out this Form:*

 First Name Last Name
Date of this Grant Application:* (mm/dd/yyyy)
For this camper child, are you eligible for applying for the $1250 first-timer grant or the $750 second-timer grant?*
(For camper eligibility, please check How The Program Works)
$1250 first-timer grant
$750 second-timer grant
Have you applied to one of the participating camps yet?*
No, I have not yet applied for camp
Yes, I have applied for camp and my acceptance has been confirmed
I have applied for camp, but I am on a waiting list
I have applied for camp, but I do not know the status of my application
       
Name of Camp:* Camp Session:*
Length of Session :*
(Please Round Up) 		   

SECTION #1 – CAMPER SECTION
       
First Name:* Last Name:*
Male/Female:* Male Female Date of Birth:* (mm/dd/yyyy)
Current Grade:* School Name:*
       
Street:* City:*
Postal Code:* Phone:*
(Phone no. should not contain any dashes)
Age:*    

SECTION #2 – PARENT/GUARDIAN SECTION
       
First Name of Parent/Guardian 1:* Last Name:*
Occupation:*    
  Address same as section1    
Street:* City:*
Postal Code:* Home Phone:*
(Phone no. should not contain any dashes)
Email:* Work Phone:*
(Phone no. should not contain any dashes)
       
First Name of Parent/Guardian 2: Last Name
Occupation:    
  Address same as section1    
Street: City:
Postal Code: Home Phone:
Email: Work Phone:

SECTION #3 – BACKGROUND INFORMATION
       
PLEASE TELL US ABOUT YOUR CHILD…
       
What is the main type of Jewish schooling he/she is receiving this year? *
None
Sunday school or another one-day-per-week school
A religious school that meets two days per week
A religious school that meets three days per week
Other
       
Has your child ever been to Israel? *
Yes   No
       
       
PLEASE TELL US ABOUT YOURSELF…
       
What denomination do you currently consider yourself to be? *
Orthodox   Traditional  Conservative Reform
Reconstructionist  Secular Other Jewish    
       
       
Have you or your spouse/partner ever been to Israel? *
Yes   No
       
What is the main type of Jewish schooling you received as a child, if any? *
None
Sunday school or another one-day-per-week school
A religious school that meets two days per week
A religious school that meets three days per week
Jewish day school
Other
       
Who among the following in your family has attended overnight camp?(check all that apply) *
You
Your spouse/partner  
Child 
Child's sibling
No one
       
Who among the following in your family has attended a Jewish sponsored overnight camp? (check all that apply) *
You
Your spouse/partner  
Child 
Child's sibling
No one
       
Are you currently: *
Married
Single/never married 
Divorced or separated 
Widowed
Living with someone in a committed relationship
       

How did you find out about the Top Bunk program? *

SECTION #4 –ACKNOWLEDGEMENT, AGREEMENT, AND RELEASE
       

In submitting this application, I certify that my child meets all the criteria for eligibility to receive an Incentive Grant for the 2010 summer through the TopBunk program.

I also acknowledge that, in the spirit of making Jewish overnight camp an immersive experience, eligible camp sessions must be a minimum of three weeks, and that failure to attend for this minimum amount of time will result in the forfeiting of this grant.

Finally, I acknowledge that all information on this Grant Application is accurate and complete, and I understand that incomplete applications will be rejected.

 
I have read and agree to the Terms of Use and Privacy Policy.*
 
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