CBC Campership Application

CBC Campership Application

Campers must be year-round residents of Hancock County, Maine. All applications are handled confidentially. This form may take several minutes to complete and will ask for information from your latest tax filing so we recommend that you assemble these materials before starting the campership application. If you have any questions about the campership application process, please call our office manager at (207)244-0365. Thank you.
Is the camper(s) a year-round resident of Hancock County Maine?*

YesNo
STOP. At this time Campership Assistance Funds are reserved for families of Hancock County campers.

Parent(s) or Guardian(s) at Camper's Permanent Address
Parent/Guardian 1*

First NameLast Name
Relationship to Camper*
Parent/Guardian 1 Employer
Parent/Guardian 1 Occupation
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Parent/Guardian 2 at the same address

First NameLast Name
Relationship to Camper
Parent/Guardian 2 Employer
Parent/Guardian 2 Occupation
Phone Number

Area CodePhone Number
E-mail
Parent or Guardian at Different Address, Responsible for Childcare Payments

If applicable
Full Name

First NameLast Name
Relationship to Camper
Employer
Occupation
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number

Area CodePhone Number
E-mail
if available

Enter Camper info

Total Camper Weeks:
Value calculated from fields above. Please do not edit this field.
Weekly Amount You Can Pay PER CHILD:*
Enter an amount that you can realistically pay each week for each of your children.
Requested total of family contribution for the entire summer:
Value calculated from fields above. Please do not edit this field.
The amount above would be the total amount you would have to pay for the weeks of camp you hope to receive for your camper(s). You may not receive the full award you are requesting, however. Once you receive your award, we encourage all families to begin payments as soon as possible so as to avoid falling behind.
Estimated Campership Request

Additional Supporting Materials
Campership funds are limited and experience shows that the local need is great. Household income is not the only factor taken into account in determining campership awards but obviously, it is a major factor. Please use the space below to tell us about any family or personal circumstances you think may be helpful for us in making a decision regarding your request. This is particularly important if your 'on-paper' household income might otherwise disqualify acceptance.
Household narrative.*
This text box is unlimited.
REQUIRED - Use the button below to upload a copy of your current complete tax return, including all schedules. This is the return which is/was due in April of this year. You may also elect to fax (207-244-3355), mail (PO Box 381, Mount Desert, ME 04660), or deliver these records personally (264 Beech Hill Rd, Mount Desert). This information is required to process your application.

Upload your tax documents
Use this button to upload your current tax documents. Cancelof

Signature
By signing and submitting this form, I am certifying that all the information provided is true and correct and that all income is reported.
Enter Name of Parent/Guardian signing this form:
Signature of Parent/Guardian Responsible for Payment:*

Clear
Date

MonthDayYear
DateHourMinutesAM/PM Option

	Parents/Guardians at camper's permanent address:	Parents/Guardians at different address:
Gross Wages
Social Security
Child Support
Workman's Comp
Pensions
Unemployment
AFDC, Alimony
Public Assistance
Other

Parent(s) or Guardian(s) at Camper's Permanent Address