2023 Scholarship Application
Dottie Rose is excited to have this opportunity to award camp scholarships to deserving children. We offer full and partial scholarship opportunities, these are income based.
Guardian information
Guardian 1:
First Name
Last Name
Relation to Child
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Guardian #1 Employment Information
Job title
Company name
City
Point of Contact
Number
Guardian 2:
First Name
Last Name
Relation to Child
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Guardian #2 Employment Information
Job title
Company name
City
Point of Contact
Number
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Scholarship Applicant Information:
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Additional Information:
School attending
Street Address Line 2
Grade level
Age
Date of Birth
Any Extra Curricular Activities Child Participates In? (school clubs, volunteer work)
What summer camp or workshop are you applying for?
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Income Section
Please answer this section truthfully and to the best of your ability. Fabrication of information is not allowed. Verification of income can be requested (Tax return or pay check stubs)
Household: (You must fill out all information in this section for consideration. Failure to do so will eliminate your child from this opportunity)
Household Income
Street Address Line 2
Household Total (Children + Adults)
Total Adults in Household (over 18)
Total Children in household
Tell us more!
In this section let us know some fun facts about your child, we want to get to know your child more! Feel free to brag or let us know about your child’s interest in STEM careers and how getting this scholarship will impact them.
Submit
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