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Request for Stipend from Eitan Hillel Travel Fund

Request for Stipend from Eitan Hillel Travel Fund

Eitan Hillel Travel Tzedakah Fund

The Eitan Hillel Travel Tzedakah Fund has been set up in memory of Eitan Hillel ben Mishael vChanah Esther
 

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.

   
First Name:   
Last Name:  
Home Phone:  
Work Phone:  
Cell Phone:  
Email Address:  
Confirm Email Address:  
Street Address:  
City:  
State:  
Zip:  
   
Please explain briefly the purpose of the proposed travel
 

 

Please explain why you find the need to apply to the fund.

 
 

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.

 
 

What is the date and destination of the proposed trip?

 
 

What is the anticipated cost of tickets?

 
 

How much of cost of travel will be you be able to provide yourself, and how much are you requesting from the Fund?

 
   

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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