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College Tuition not applicable
Student name/s
College/s attending
Total tuition cost
Have you or your student/s applied for and received student loans or grants? YES NO
What has the college awarded you in tuition assistance?
What is the net cost to you for tuition each year?
Summer Camp/Program not applicable
List each of your children who will attend Jewish camp this summer the name of the of camp name and amount you paid per child
Name Name
Camp/Program Name Camp/Program Name
Cost Your cost Cost Your cost
Name Name
Camp/Program Name Camp/Program Name
Cost Your cost Cost Your cost
Synagogue not applicable
Do you belong to a synagogue? YES NO
If yes, please write the synagogue name here
Annual Dues Adjusted Dues
If the synagogue has reduced your membership, please put the net amount you pay per year.
Tuition Assistance (TA) Supplemental InformationThe information provided on this form will give our TA committee a more accurate picture of your financial situation. The committee will use this information to determine TA. Please complete and fax to FACTS Management Company at 866-315-9264.
Date Parent
Student