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	Lackman Family Scholarship Fund Application - Chabad of Southlake
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Their kindness allows us to work individually with each family to determine a mutually agreed upon price, making it possible for everyone to participate.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\n\u003cp style=\"text-align: justify;\"\u003e\u003cspan style=\"color:#16a085;\"\u003e\u003cspan style=\"font-size:18px;\"\u003eYou must have\u0026nbsp;turned in a completed\u0026nbsp;\u003ca href=\"/article.asp?AID=5012232\"\u003eregistration form\u003c/a\u003e and\u0026nbsp;deposit before you can be considered for a scholarship.\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003cspan style=\"font-size:18px;\"\u003e\u003cspan style=\"color:#16a085;\"\u003ePlease be sure to fill out the entire form.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n","1_name":"doubleclickTo","1_qid":1,"1_type":"control_text","1_order":1,"3_text":"Parent Name","3_message":"","3_labelAlign":"Auto","3_required":"Yes","3_prefix":"No","3_suffix":"No","3_middle":"No","3_description":"","3_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"3_readonly":"No","3_name":"parentName","3_qid":3,"3_type":"control_fullname","3_order":2,"4_text":"Camper Name","4_message":"","4_labelAlign":"Auto","4_required":"Yes","4_prefix":"No","4_suffix":"No","4_middle":"No","4_description":"","4_sublabels":{"prefix":"Prefix","first":"First Name","middle":"Middle Name","last":"Last Name","suffix":"Suffix"},"4_readonly":"No","4_name":"camperName","4_qid":4,"4_type":"control_fullname","4_order":3,"6_receivesReceipts":"No","6_text":"Parent E-mail","6_message":"","6_labelAlign":"Auto","6_required":"Yes","6_size":30,"6_validation":"Email","6_maxsize":"","6_defaultValue":"","6_subLabel":"","6_hint":"ex: myname@example.com","6_description":"","6_confirmation":"No","6_confirmationHint":"Confirm Email","6_readonly":"No","6_name":"parentEmail","6_qid":6,"6_type":"control_email","6_order":4,"8_text":"Phone Number","8_message":"","8_labelAlign":"Auto","8_required":"Yes","8_validation":"Numeric","8_countryCode":"No","8_inputMask":"disable","8_inputMaskValue":"(###) ###-####","8_description":"","8_sublabels":{"country":"Country Code","area":"Area Code","phone":"Phone Number","full":"Phone Number"},"8_readonly":"No","8_name":"phoneNumber","8_qid":8,"8_type":"control_phone","8_order":5,"9_text":"\u003cp style=\"text-align: justify;\"\u003e\u003cspan style=\"color:#16a085;\"\u003e\u003cspan style=\"font-size: 18px;\"\u003eI/We would like to benefit from the Lackman family scholarship fund. As we allocate funds to cover the tuition for participating families/campers, please review some of the scholarship options that Camp Gan Israel will be providing this year.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\n\u003cp style=\"text-align: justify;\"\u003e\u003cspan style=\"color:#16a085;\"\u003e\u003cspan style=\"font-size: 18px;\"\u003eOption 1) At CGI we understand the challenge of paying the tuition price all at once, or even before the summer, therefore we can allow post dated checks through September (or later if need be), making the tuition payment more manageable.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\n\u003cp\u003e\u003cspan style=\"color:#16a085;\"\u003e\u003cspan style=\"font-size: 18px;\"\u003eOption 2) Entitles the family to a 10% reduction from tier 3 early bird price.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\n\u003cp\u003e\u003cspan style=\"color:#16a085;\"\u003e\u003cspan style=\"font-size: 18px;\"\u003eOption 3) Entitles the family to a 15% reduction from tier 3 early bird price.\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\n\u003cp\u003e\u003cspan style=\"color:#16a085;\"\u003e\u003cspan style=\"font-size: 18px;\"\u003eOption 4) None of these are sufficient. I would like someone to call me about setting up another arrangement. \u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n","9_name":"doubleclickTo9","9_qid":9,"9_type":"control_text","9_order":6,"10_text":"We would like","10_message":"","10_labelAlign":"Auto","10_required":"Yes","10_options":"Option 1|Option 2|Option 3|Option 4","10_special":"None","10_allowOther":"No","10_otherText":"Other","10_calculateOther":"No","10_selected":"","10_spreadCols":"1","10_description":"","10_name":"weWould","10_qid":10,"10_type":"control_radio","10_order":7,"11_text":"\u003cp style=\"text-align: justify;\"\u003e\u003cspan style=\"color:#16a085;\"\u003e\u003cspan style=\"font-size: 18px;\"\u003eAll requests for assistance must be received by\u0026nbsp;\u003cstrong\u003eMay 15th\u003c/strong\u003e.\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\n\u003cp style=\"text-align: justify;\"\u003e\u003cspan style=\"color:#16a085;\"\u003e\u003cspan style=\"font-size: 18px;\"\u003ePlease note, you must have\u0026nbsp;turned in a completed\u0026nbsp;registration form and\u0026nbsp;deposit before you can be considered for a scholarship. Deposit will be\u0026nbsp;fully refunded\u0026nbsp;if your request cannot be accommodated.\u0026nbsp;\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\n\u003cp style=\"text-align: justify;\"\u003e\u003cspan style=\"color:#16a085;\"\u003e\u003cspan style=\"font-size: 18px;\"\u003e\u003cstrong\u003eWhen submitting a camp scholarship request form, please consider the cost of these programs.\u003c/strong\u003e\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n","11_name":"doubleclickTo11","11_qid":11,"11_type":"control_text","11_order":8,"2_text":"Submit","2_buttonAlign":"Center","2_clear":"No","2_print":"No","2_name":"submit","2_qid":2,"2_type":"control_button","2_order":9,"form_title":"Scholarship Request Form","form_pagetitle":"Form","form_styles":"nova","form_font":"","form_fontsize":"18","form_fontcolor":"","form_optioncolor":"","form_lineSpacing":"12","form_background":"","form_formWidth":"765","form_labelWidth":"150","form_alignment":"Top","form_thankurl":"","form_thanktext":"","form_highlightLine":"Enabled","form_activeRedirect":"default","form_sendpostdata":"No","form_unique":"None","form_uniqueField":"\u003cField Id\u003e","form_status":"Enabled","form_injectCSS":"","form_hideMailEmptyFields":"disable","form_showProgressBar":"disable","form_formStrings":[{"alphabetic":"This field can only contain letters","alphanumeric":"This field can only contain letters and numbers.","confirmClearForm":"Are you sure you want to clear the form?","confirmEmail":"E-mail does not match","email":"Enter a valid e-mail address","generalError":"There are errors on the form. 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<form class="userform-form" action="" method="post" name="form_3232278" id="3232278" accept-charset="utf-8"><input type="hidden" name="formID" value="3232278" /><div class="form-all dir_ltr" dir="ltr"><ul class="form-section"><li class="form-line" id="id_1"><div id="cid_1" class="form-input-wide"> <div id="text_1" class="form-html"><p style="text-align: justify;"><span style="font-size:18px;"><span style="color:#16a085;">At CGI, we strive to make our summer camp accessible to everyone, as we firmly believe that a Jewish camping experience is a vital part of developing a strong Jewish identity. This has been made possible by the generosity of the <strong>Lackman family.</strong></span></span></p>

<p style="text-align: justify;"><span style="font-size:18px;"><span style="color:#16a085;">Thanks to the <strong>Lackman family,</strong> we are able to open our doors to all who seek assistance, ensuring that financial constraints do not prevent anyone from enjoying the enriching camp experience. Their kindness allows us to work individually with each family to determine a mutually agreed upon price, making it possible for everyone to participate.</span></span></p>

<p style="text-align: justify;"><span style="color:#16a085;"><span style="font-size:18px;">You must have turned in a completed <a href="/article.asp?AID=5012232">registration form</a> and deposit before you can be considered for a scholarship. </span></span><span style="font-size:18px;"><span style="color:#16a085;">Please be sure to fill out the entire form.</span></span></p>
</div> </div></li><li class="form-line" id="id_3"><div class="form-label-top" id="label_3"><label for="input_3"> Parent Name<span class="form-required">*</span> </label><label class="label-message" for="input_3"> </label></div><div id="cid_3" class="form-input-wide"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q3_parentName[first]" id="first_3" autocomplete="given-name" />  <label class="form-sub-label" for="first_3" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q3_parentName[last]" id="last_3" autocomplete="family-name" />  <label class="form-sub-label" for="last_3" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_4"><div class="form-label-top" id="label_4"><label for="input_4"> Camper Name<span class="form-required">*</span> </label><label class="label-message" for="input_4"> </label></div><div id="cid_4" class="form-input-wide"> <span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="10" name="q4_camperName[first]" id="first_4" autocomplete="given-name" />  <label class="form-sub-label" for="first_4" id="sublabel_first">First Name</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required]" type="text" size="15" name="q4_camperName[last]" id="last_4" autocomplete="family-name" />  <label class="form-sub-label" for="last_4" id="sublabel_last">Last Name</label></span> </div></li><li class="form-line" id="id_6"><div class="form-label-top" id="label_6"><label for="input_6"> Parent E-mail<span class="form-required">*</span> </label><label class="label-message" for="input_6"> </label></div><div id="cid_6" class="form-input-wide"> <input type="email" class=" form-textbox validate[required, Email]" id="input_6" name="q6_parentEmail" size="30" value="" autocomplete="email" /> </div></li><li class="form-line" id="id_8"><div class="form-label-top" id="label_8"><label for="input_8"> Phone Number<span class="form-required">*</span> </label><label class="label-message" for="input_8"> </label></div><div id="cid_8" class="form-input-wide"> <div class="dir_ltr"><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q8_phoneNumber[area]" id="input_8_area" autocomplete="tel-area-code" maxlength="5" size="3" />  <label class="form-sub-label" for="input_8_area" id="sublabel_area">Area Code</label></span><span class="form-sub-label-container"><input class="form-textbox validate[required, Numeric]" type="tel" name="q8_phoneNumber[phone]" id="input_8_phone" autocomplete="tel-local" size="8" />  <label class="form-sub-label" for="input_8_phone" id="sublabel_phone">Phone Number</label></span></div> </div></li><li class="form-line" id="id_9"><div id="cid_9" class="form-input-wide"> <div id="text_9" class="form-html"><p style="text-align: justify;"><span style="color:#16a085;"><span style="font-size: 18px;">I/We would like to benefit from the Lackman family scholarship fund. As we allocate funds to cover the tuition for participating families/campers, please review some of the scholarship options that Camp Gan Israel will be providing this year.</span></span></p>

<p style="text-align: justify;"><span style="color:#16a085;"><span style="font-size: 18px;">Option 1) At CGI we understand the challenge of paying the tuition price all at once, or even before the summer, therefore we can allow post dated checks through September (or later if need be), making the tuition payment more manageable.</span></span></p>

<p><span style="color:#16a085;"><span style="font-size: 18px;">Option 2) Entitles the family to a 10% reduction from tier 3 early bird price.</span></span></p>

<p><span style="color:#16a085;"><span style="font-size: 18px;">Option 3) Entitles the family to a 15% reduction from tier 3 early bird price.</span></span></p>

<p><span style="color:#16a085;"><span style="font-size: 18px;">Option 4) None of these are sufficient. I would like someone to call me about setting up another arrangement.  </span></span></p>
</div> </div></li><li class="form-line" id="id_10"><div class="form-label-top" id="label_10"><label for="input_10"> We would like<span class="form-required">*</span> </label><label class="label-message" for="input_10"> </label></div><div id="cid_10" class="form-input-wide"> <div class="form-single-column"><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_10_0" name="q10_weWould" value="Option 1" /><label id="label_input_10_0" for="input_10_0"><span>Option 1</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_10_1" name="q10_weWould" value="Option 2" /><label id="label_input_10_1" for="input_10_1"><span>Option 2</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_10_2" name="q10_weWould" value="Option 3" /><label id="label_input_10_2" for="input_10_2"><span>Option 3</span></label></span><span class="clearfix"></span><span class="form-radio-item clear-left"><input type="radio" class="form-radio validate[required]" id="input_10_3" name="q10_weWould" value="Option 4" /><label id="label_input_10_3" for="input_10_3"><span>Option 4</span></label></span><span class="clearfix"></span></div> </div></li><li class="form-line" id="id_11"><div id="cid_11" class="form-input-wide"> <div id="text_11" class="form-html"><p style="text-align: justify;"><span style="color:#16a085;"><span style="font-size: 18px;">All requests for assistance must be received by <strong>May 15th</strong>. </span></span></p>

<p style="text-align: justify;"><span style="color:#16a085;"><span style="font-size: 18px;">Please note, you must have turned in a completed registration form and deposit before you can be considered for a scholarship. Deposit will be fully refunded if your request cannot be accommodated. </span></span></p>

<p style="text-align: justify;"><span style="color:#16a085;"><span style="font-size: 18px;"><strong>When submitting a camp scholarship request form, please consider the cost of these programs.</strong></span></span></p>
</div> </div></li><li class="form-line" id="id_2"><div id="cid_2" class="form-input-wide"> <div style="text-align: center;" class="form-buttons-wrapper button-align-center"><button id="input_2" type="submit" class="form-submit-button  form-submit-button-none;">Submit</button></div> </div></li><li style="display:none">Should be Empty: <input type="text" name="website" value="" /></li></ul></div><input type="hidden" id="simple_spc" name="simple_spc" value="3232278" /><script type="text/javascript">document.getElementById("si"+"mple"+"_spc").value = "3232278-3232278";</script></form></div>
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