Teen Leadership Development

Request for Subsidy

 

Teen Name: ____________________________________________________

Address: ______________________________________________________

______________________________________________________________

Telephone: _____________________________________________________

 

Program Attended: _____________________________________________

Date(s) of Participation: _________________________________________

Total Cost of Participation: _______________________________________

Synagogue/Youth Group Subsidy: NO YES Amount of Subsidy:_____

 

Custodial Parent Information (check will be made out to the parent)

Name: ________________________________________________________

Address: ______________________________________________________

______________________________________________________________

 

Youth Signature: _______________________________________________

Youth Group Advisor/Rabbi Signature: ___________________________

Family must be a member in good standing with the Federation to receive this subsidy. Minimum annual contribution of $100 is required.

There is a $50 per event subsidy available annually for “Bonafide” leadership training events. This subsidy does not include Shabbatons, Conclavettes, or similar social programs.

 

Mail completed application with a copy of your leadership program application to:

Attn: Teen Leadership
Jewish Federation of NH
698 Beech St.
Manchester, NH 03104