Please note all applications received after May 1st will be placed on a waiting list.
For further questions, you can reach out to Awartelsky@achiezer.org.
Thank you for understanding!

Dear Applicant,

Please fill out the form below to apply for a Camp Scholarship.

You will receive an email confirmation once you have submitted your application.

Do not expect any response before Mid-May. We will notify you after that date of the status of your application. Applications will be marked approved/denied/pending funding.

Please note: Filling out an application is not a guarantee.

Please note: If you did not receive a confirmation Email, your application was NOT received. If you tried submitting an application and did not receive a confirmation E-mail, please contact our office at (516) 791-4444.
Parent/Guardian Information
First Name: *
Last Name: *
Address: *
Neighborhood *
Phone Number: *
Email Address: *
Shul Affiliation: *
Rabbi: *
Rabbi Phone: *
Marital Status: *
           
Children Information
Amount of Children Attending Camp *


Are you receiving a Camp Tuition Break?
       
Please list all help






What is your Oustanding Camp Balance? *
Additional Comments or any extenuating circumstances:
I affirm that all funds are needed *
   
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