Thrive and Camp Wild Heart Scholarship Request Form

1

Parent/Guardian Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Area Code

Phone Number

4

List children's names and ages you are hoping to get scholarships for:* This field is required.

5

Which scholarship does your family need?* This field is required.

Partial Scholarship - Part or half-off the program cost; either Thrive STEAM Enrichment or Camp Wild Heart

Full Scholarship - We cannot afford any out-of-pocket cost.

6

Notes regarding scholarship request:

7

Which programs are you interested in having your child attend?* This field is required.May choose multiple.

Thrive STEAM Enrichment Program

Summer camp at Camp Wild Heart

School break camps at Camp Wild Heart

8

Is your child currently enrolled at Thrive or Camp Wild Heart?* This field is required.

YESNO

9

Has your child ever attended Thrive or Camp Wild Heart before?* This field is required.

YESNO

10

If yes, your child has attended Thrive, which year(s) did they attend?

2021-22

2022-23

2023-24

11

What is your household size?* This field is required.

12

Do you receive SNAP/Cal Fresh/Medi-Cal benefits?* This field is required.

YESNO

14

Additional Notes or Information you'd like to add