Queer Talmud Camp Scholarship Application

Queer Talmud Camp Scholarship Application
First Name
Last Name
Birth Date	// (MM/dd/yyyy)
Email
Address 1
City
State	ALABAMAALASKAARIZONAARKANSASCALIFORNIACOLORADOCONNECTICUTDELAWAREDISTRICT OF COLUMBIAFLORIDAGEORGIAHAWAIIIDAHOILLINOISINDIANAIOWAKANSASKENTUCKYLOUISIANAMAINEMARYLANDMASSACHUSETTSMICHIGANMINNESOTAMISSISSIPPIMISSOURIMONTANANEBRASKANEVADANEW HAMPSHIRENEW JERSEYNEW MEXICONEW YORKNORTH CAROLINANORTH DAKOTAOHIOOKLAHOMAOREGONPENNSYLVANIARHODE ISLANDSOUTH CAROLINASOUTH DAKOTATENNESSEETEXASUTAHVERMONTVIRGINIAWASHINGTONWEST VIRGINIAWISCONSINWYOMINGAMERICAN SAMOAFEDERATED STATES OF MICRONESIAGUAMMARSHALL ISLANDSNORTHERN MARIANA ISLANDSPALAUPUERTO RICOU.S. MINOR OUTLYING ISLANDSVIRGIN ISLANDSARMED FORCES AMERICASARMED FORCESARMED FORCES PACIFICALBERTABRITISH COLUMBIAMANITOBANEW BRUNSWICKNEWFOUNDLAND AND LABRADORNOVA SCOTIANORTHWEST TERR.NUNAVUTONTARIOPRINCE EDWARD ISLANDQUEBECSASKATCHEWANYUKON
Please answer a few questions about yourself to help us understand your needs.
What is your source of income?
What is your current annual income?
Do anyone help support you financially (e.g. spouse, parents, etc.)?
Queer Talmud Camp is already generously subsidized, why do you require additional subsidy to attend Queer Talmud Camp?
Which retreat do you plan to attend? Perlstein Resort, June 11-15Walker Creek Ranch, July 2-6
Lodging type*:	Camping, $400Dorm-style, $650 (Walker Creek only)Shared, $750 (Perlstein only)
*We are only able to provide additional subsidies for camping or shared lodging.
Tuition to Queer Talmud Camp for these types of lodging is already generously subsidized $300-$500 by our donors and grant funding. How much additional scholarship do you require to attend Queer Talmud Camp?
While we have limited scholarship funds, we are able to set up a payment plan where you pay a little bit each month. Payment plans are not refundable. Please check this box if you would rather pursue a payment plan. Yes! I would like to set up a payment plan.
Over how many months would you like to disperse your payments? Tuition must be received in full one week before camp begins.
Queer Talmud Camp has a lean budget. What other avenues are you pursuing to cover the costs of Queer Talmud Camp for yourself We suggest you consider: synagogue scholarships, GoFundMe campaigns, garage sales, etc.