CPLC Scholarship Application Form

CPLC SCHOLARSHIP APPLICATION FORM

Dear Parents,

We are pleased to announce that Chabad Pico Learning Center is now accepting scholarship applications for the upcoming academic year. We understand that the cost of education can be a burden for families, and we strive to provide financial assistance to those in need.

To apply for a scholarship, please fill out the attached form, which includes questions about your financial situation and need for assistance. It is important to note that submitting your tax return for 2022 is a requirement for us to consider your request.

Our scholarship committee will carefully consider all applications and make decisions based on the information provided. Please note that completion of this form does not guarantee approval of a scholarship.

We encourage all families who require financial assistance to apply and we look forward to working with you.

Sincerely,

Rabbi Moshe Levin

Please fill out all sections of this form to the best of your ability. All information provided will be kept confidential.

Personal Information

First Name *

Last Name *

Street Address *

City *

Postal Code *

State/Province *

Phone Number *

Email *

Student Information

First Name *

Last Name *

Birth Date *

Month

Day

Year

Child's grade *

Child's current school *

Family Information

Number of family members in household *

Total annual household income (before taxes) *

Number of dependents in college or vocational school *

Do you rent or own your home? *

Monthly rent/mortgage payment *

Scholarship Request

Please describe your financial need and how a scholarship would assist your family with educational costs *

Supporting Documents

Please attach a copy of your tax return for 2022 and any other relevant financial documents to support your application *

Files must be less than 5 MB.
Allowed file types: jpg jpeg png pdf.

I certify that the information provided on this application is true and accurate to the best of my knowledge *

I certify that the information provided on this application is true and accurate to the best of my knowledge

Signature *

Today's Date *

Month

Day

Year