KI Youth Scholarship Request Form

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This is a confidential form that will be automatically submitted to the KI Executive Director who will share the information with a small lay group without personal identification information. Questions? Call 215-887-8700.

* Parent(s) Name(s)

* Contact Email

* Contact Phone

Student Name

Student Grade

Student's Activities at KI

JQuest/Quest NoarShir Joy or Teen ChoirMadrich(a) or KI Office volunteerKIFTY officerKIFTY or Club KIFTY ParticipantRegular HaMotzi dinner volunteerOther (indicate below)

Parents, please share your volunteer efforts at KI?

Have you received assistance with your KI membership contribution this year?

YesNo

Has your child received tuition adjustment for JQuest/Quest Noar this year?

YesNo

Program you are applying for scholarship (Choose only one below- Please submit a separate form for each request)

KIFTY/NFTY eventTeen Israel TravelURJ Summer Camp (Camp Harlam, Six Points, or other)Jewish educational camp (Galil, Pinemere, Ramah)10th Grade RAC TripCivil Rights Trip (Etgar)Other (indicate below)

Cost of the program

Amount of Scholarship request

Please share if you have requested scholarship and/or financial assistance from other sources and how much you anticipate receiving.

What is your total family income from the previous year (Net income including salary, commission, interest/dividends, business income)

Below $100,000$100,000-$200,000$200,000-$300,000Above $300,000

Please share the need for scholarship and reasons for the request.

KI requests the following:

That all scholarship participants pledge to continue participating in KI's educational programs through Confirmation
That all parents receiving scholarship find a way to give back to the KI community through volunteering
KI scholarship recipients must be current with their synagogue membership and regularly attend educational activities

Upon submission your request will be processed and you will be notified shortly of the scholarship.

Wed, February 11 2026 24 Shevat 5786

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