Tell us about you Full Name* First Name Last Name E-mail* Phone Number* Area Code Phone Number Mailing Address* Street Address Street Address Line 2 City State / Province Postal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOther Country Hebrew Name Gender* MaleFemale Date of Birth* 1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December Month12345678910111213141516171819202122232425262728293031 Day202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 Year High School Attending* What grade are you going into this coming school year of 2024/2025?* FreshmanSophomoreJuniorSenior Semester(s) you would like to attend:* minimum 1 semester required Semester 1 (starting Sep 8)Semester 2 (starting Nov 17)Semester 3 (starting Feb 2)Semester 4 (starting March 16) Tell us about your family Fathers Name* First Name Last Name Fathers Cell* Area Code Phone Number Fathers E-mail* Mothers Name* First Name Last Name Mothers Cell* Area Code Phone Number Mothers E-mail* Calendar Semester #1 09/08/2024 09/15/2024 09/22/2024 09/29/2024 11/03/2024 11/10/2024 Semester #2 11/17/2024 11/24/2024 12/8/2024 12/15/2024 01/12/2025 01/28/2025 Semester #3 02/02/2025 02/09/2025 02/16/2025 02/23/2025 03/02/2025 03/09/2025 Semester #4 03/16/2025 04/06/2025 04/27/2025 05/04/2025 05/11/2025 05/18/2025 Grant Amounts Program Grant (pending fulfillment of requirements) 9th Grade Semester 1: $100 Semester 2: $100 Semester 3: $100 Semester 4: $100 10th Grade Semester 1: $125 Semester 2: $125 Semester 3: $125 Semester 4: $125 11th Grade Semester 1: $150 Semester 2: $150 Semester 3: $150 Semester 4: $150 12th Grade Semester 1: $175 Semester 2: $175 Semester 3: $175 Semester 4: $175 9th Grade Total: $400 10th Grade Total: $500 11th Grade Total: $600 12th Grade Total: $700 Grant Requirements: • Attendance: Must have an attendance rate of 70% or higher (per semester) • Volunteer: Must volunteer at one (1) Chabad or friendship house event (per semester) • Participation: Must score higher than 60% on end of semester quiz, administered on last class of each semester. Attendance Requirement The Attendance requirement is to have an attendance rate of 70% or higher per semester (that is to attend 5 out of 6 weeks). Attendance Bonus: If you attend all 6 weeks with no tardies = $25 extra I have read and agree to the attendance requirement.* I accept Volunteering Requirement The Sinai Scholars Leadership program is proud to be partnering with Chabad of West Boca and the Friendship House. The volunteering requirement is to volunteer one (1) time per semester. Chabad of West Boca is guided by the idea that there should be a place where everyone can feel at home, within a Jewish context. Aiming to reach out to every Jew and ignite the spark of Judaism in them. You can learn more about Chabad on their website ChabadWestBoca.com To volunteer at Chabad of West Boca please text Shaina Kramer at 803-553-2897 The Friendship House provides support to individuals with special needs and their families by providing recreational, social, and educational programming. You can learn more about the Friendship House on their website bocafriendship.com To volunteer at The Friendship House please text Rabbi Sholom Kessler at 561-788-4388 Please note: time spent volunteering can also be submitted to your school as volunteer hours. I have read and agree to the volunteering requirement.* I accept Participation Requirement Score Higher than 60% on end of semester quiz, administered on last class of each semester. I have read and agree to the participation requirement.* I accept Submit Should be Empty: This page uses TLS encryption to keep your data secure.
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