2022 Camp Scholarship Application

Camp Scholarship Application
Scholarships are designed to enable as many children as possible to have a KSS program experience by providing financial assistance to families with demonstrated financial need.

Please review the KSS Scholarship webpage for more details about the application process and guidelines for receiving a scholarship. If you need assistance filling out the application or have questions you can also contact us at (970)468-2098 or Support@KeystoneScienceSchool.org.
Family Information
Primary Parent/ Guardian Name *

First Name Last Name
Primary Parent/ Guardian Phone Number *
Primary Parent/ Guardian Email *
example@example.com
Camper(s) Name(s) Gender(s) and Grade(s) *
City of residence *
County of residence *
Primary language spoken in the home *
Number of adults in the household *
Number of children in the household *
Please list the relationship of adults to the child(ren) being enrolled in the program (mother, father, aunts, uncles, etc.) *
Has the participant(s) attended KSS programs previously? *
If yes, which programs?
Financial Needs
Does your family qualify for any of the following federal or state-based assistance? (Check all that apply) *
Please select the income range of your household *
In detail, please explain why financial aid is necessary for your family. Include relevant information about your current employment status and your financial situation. *
Childcare & Outcomes
If my child was not in this program they would have these care options (select all that apply) *
If other, please describe.
What do you and your child hope to gain from this KSS experience? *
Please indicate desired program, sessions, and for which camper *
Please note:
- Some data and information will be included within grant reports. Personal identification will not be shared in this process.
- All financial information on this form is confidential and is used exclusively by Keystone Science School and the Camp Scholarship committee of volunteers for the purpose of assessing scholarship eligibility.
- Please note, that if a child is awarded a campership, the camper will be asked to write about his/her summer camp experience so we can share this with our donors. Campers’ names will be kept confidential at all times.
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Camp Scholarship Application

Family Information

Financial Needs

Childcare & Outcomes