Request an Application

Name*

Address*

Street Address

City

State

County

ZIP Code

Email*

Home Phone*

Cell Phone

Loan Type*

Loan Program*

Reason for Loan

Some of our loan programs require that you are Jewish or have a connection to the Jewish community. Others are non-sectarian. Even for those programs, we collect information about your relationship to the Jewish community for statistical purposes.

Indicate your relationship to the Jewish community*

(choose one)

I am Jewish.
I am not Jewish, but I work for a Jewish communal agency.
I am not Jewish and have no connection to the Jewish community.

Which Jewish communal agency do you work for?

What connection do you have to the Jewish community?

How did you learn about us?

(check all that apply)

Describe how did you learn about HFL?

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