The Millstone Scholars Program 2025-2026

Student Type

Is your child a new or returning student?

Returning StudentNew Student

Please select a location by typing in the two letter abbreviation for your state:

If you are attending by vitrually, please search for "zoom"

My location does not appear in the dropdown above

Product Code Name

Coupon Code

Product Code

City

State/Province

Student Information

Please note:

Our teachers would like to communicate directly with applicants and students for the purposes of discussing course work. Please provide contact information for your child below.

Child's First Name

Child's Last Name

Childs Date of Birth

Please make sure the correct year is entered.

Child's Gender

MaleFemale

Headshot of Child

Child's Phone (Optional)

Child's email address (Optional)

What grade is your child starting this fall?

School Information

Please select the student's school from the dropdown below

School Affiliation

Student's school does not appear on the dropdown list

What is the name of the Student's school?

Which of the following best describes your current school?

Public SchoolPrivate SchoolJewish Day SchoolHomeschool

Has your address changed in the last year?

YesNo

Address

City

State/Province

Postal Code

Country

Parent/Guardian #1 Information

Parent/Guardian #1 Title

Parent/Guardian #1 First Name

Parent/Guardian #1 Last Name

Parent/Guardian #1 Email

Parent/Guardian #1 Phone Number

Address

Please check here if Parent #1 has the same address as the student

Address

City

State/Province

Postal Code

Country

Parent/Guardian #2 Information

Please leave this section blank if needed.

Parent/Guardian #2 Title

Parent/Guardian #2 First Name

Parent/Guardian #2 Last Name

Parent/Guardian #2 Email

Parent/Guardian #2 Phone Number

Address

Please check here if Parent #2 has the same address as the student

Address

City

State/Province

Postal Code

Country

Tikvah History

How did you hear about the program?

Student Bio: Please tell us about yourself.
(2-3 sentences Required)

Name a historical figure you admire and why:
(3 to 4 sentences)

Please list your most significant interests, extracurricular activities, hobbies, and awards:

Stripe Customer ID

Stripe Setup Intent ID

Stripe Charge ID

Page 3

Payment Information

Do you anticipate needing a scholarship for this program?

YesNo

After submitting the application, someone from our team will reach out to discuss scholarship.

Application Fee Variable

Application Fee

Name on Card

Card Number

Code

Billing Email

Terms and Conditions

To apply for the Millstone Scholars Program, applicants must read and agree to the liability waiver and code of conduct.

By checking off this box I acknowledge that I have read and agree to the terms set forth in the Millstone Scholars Program liability waiver and code of conduct.

Parent	Friend
Teacher or Rabbi	Outreach from Tikvah staff member
Tikvah website or newsletter	Instagram or other social media
Jewish Parents Forum	Other
JCC/Local Federation