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Please complete the form below to apply for a stipend from the Eitan Hillel Travel Tzedakah Fund. Your request will be reviewed by our committee as soon as possible.
As soon as a determination is made by the committee, a representative will be in touch with you. Please answer all of the questions fully. The highest degree of confidentiality will be maintained.
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| First Name: |
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| Last Name: |
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| Home Phone: |
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| Work Phone: |
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| Cell Phone: |
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| Email Address: |
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| Confirm Email Address: |
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| Street Address: |
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| City: |
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| State: |
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| Zip: |
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| Please explain briefly the purpose of the proposed travel |
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Please explain why you find the need to apply to the fund.
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Please provide the name and contact of a reference familiar with your situation. This may be a Rabbi or other well-known person in the community.
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What is the date and destination of the proposed trip?
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What is the anticipated cost of tickets?
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How much of cost of travel will be you be able to provide yourself, and how much are you requesting from the Fund?
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Thank you for providing all of that information!
We look forward to being in touch with you soon.
Please review your entries for mistakes, and then press submit.
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