2025 Menucha Financial Aid Request

First Name *

Last Name *

Email

Phone 1

Address Line 1

Address Line 2

City

State/Province

Zip/Postal Code

Country

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Login Name

Password

Retype Password

Employment Status

Employed Full Time

Employed Part Time

Self-Employed

Unemployed

Retired

Sources of Income

Wages from Employment

Unemployment Benefits

Disability Benefits

Savings

Financial Assistance from a family member/partner/friend

Other - describe in Income Clarification box

Please Clarify Sources of Income

Indicate the number of people you support and their relationship to you. if you are receiving financial support from another person (family member/partner/friend), please briefly comment to clarify the extent of support.

Briefly outline why you are requesting a scholarship grant:

InIndicate amount of financial assistance you would need. 25% to 75% discount on double and triple occupancy.dicate amount of financial assistance you would need. Triple and double occupancy only.

25%

50%

75%

85% - we require a minimum of 15% from participants

Best Time of Day to Contact You

Please acknowledge cancellation policy:

I acknowledge that any cancellation within 90 days of the event will result in forfeit 50% of the amount paid by the registrant. Cancellations prior to 90 days will be refunded minus $50 administrative fee.

I agree to register within 2 weeks of being notified of my financial aid amount. If I have not registered within 2 weeks, my aid may be given to another registrant.