River Scholarship Application
Guardian’s name
*
First & Last
Relation to Camper?
*
If parents are not present where are they?
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Marital Status
*
Married
Divorced
Separated
Single
Widowed
Spouse’s Name
*
First & Last
Relationship to camper
Present Employer
*
How long ?
*
Job Title or Position
*
Employer Phone Number
Spouse’s Employer
How long?
Job Position or Title
Employer Phone Number
Camper(s) Name(s) and Age(s)
*
Is camper living with both parents?
*
Yes
No
If not, who is the primary guardian?
Has your camper attended camp?
*
Yes
No
How did you hear about camp?
*
Are you currently active in church? If so, what church?
*
How many and which weeks do you wish to send you camper?
*
Description of your financial need
*
Do you have relatives or other sources (e.g. home church) who will assist you in paying a portion of your registration?
*
Yes, No? If so, how much?
Yearly Household Income
*
Monthly Rent/Mortgage
*
Specific dollar amount you are requesting? If you have more than one child please give the total dollar amount you are requesting for the family.
*
If you have extenuating circumstances please elaborate so we can better understand your situation:
Prayer requests or other needs?
*
Submit
Should be Empty: