Teen Travel Grants

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This field is for validation purposes and should be left unchanged.

Applicant Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Applicant Email*

Parent’s email address will be requested below. Parents will be copied on all emails going to applicants currently in high school. The Travel Grant application will not be accepted without a participant email address.

Applicant Phone Number*

Is your phone a home phone or cell phone?*

Home
Cell

Birth Date*

Age*

Gender*

High School (if applicable)

College/University (if applicable)

Current Grade*

Synagogue Affiliation (if applicable)

How did you hear about Israel Travel Grants?

Israel Center website
Friend
Synagogue/School
Recipient of a previous Travel Grant
Other (please write in)

Parent(s)/Guardian Information

Parent/Guardian Name*

First Last

Parent/Guardian Address*

Street Address Address Line 2 City State ZIP Code

Parent/Guardian Email*

Parent/Guardian Phone Number*

Is your phone a home phone or cell phone?*

Home
Cell

Would you be interested in receiving information on upcoming Israel programs and trips sponsored by the Jewish Federation of St. Louis?*

Yes
No

Provide contact information for another parent or guardian?

Yes

Parent/Guardian Name

First Last

Parent/Guardian Address

Street Address Address Line 2 City State ZIP Code

Parent/Guardian Email

Parent/Guardian Phone Number

Is your phone a home phone or cell phone?

Home
Cell

Program Information

Name of Program*

Type of Program*

Short-term
Semester
Year

Date Program Begins*

If exact date is not known, include approximate departure date & return date.

Date of Return*

Grant check to be made payable to*

(NOTE: The check will be mailed directly to the program, unless a receipt is submitted for tuition paid in full.)

Address to Send Grant Check*

NOTE: US address only or you can submit wire transfer information from the program.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Israel Center

Israel Travel Grant Application

Parent(s)/Guardian Information

Program Information