2023 Girl Scouts of Greater Atlanta Summer Camp Scholarship Application

2023 Girl Scouts of Greater Atlanta Summer Camp Scholarship Application
Camp Scholarship Requirements

1. Campers must be registered for the 2022/2023 Girl Scout Memberhsip Year with the Girl Scouts of Greater Atlanta Council

2. Campers must be registered for a camp session before a camp scholarship application is processed

3. If you need to register for summer camp go to www.girlscoutsummer.com

Step 1 - Camp Information
Camp Attending (You will need to register through CampInTouch and make a deposit before a scholarship can be approved.)*
Misty Mountain Overnight Dates*
Meriwether Overnight Dates*
Timber Ridge Day Camp Dates*
Misty Mountain Session Name*
Meriwether Session Name*
Timber Ridge Day Camp Session Name*
Camper's Name*

First Name Last Name
Amount of Scholarship requested*
2022 Household Income*
Special circumstances or reason for requesting the scholarship. Give specific details to support your need:*
2023 Expected annual combined household income?*
Is the amount you expect in 2023 significantly different from 2022 (unemployment, reduced hours, divorce, medical reasons, loss of child support, retiring, death of a spouse, family size, etc.)*
Reason for the change in income.*
What amount can you pay for camp?*

Step 2 - Additional Camper Information
Camper's Troop/Juliette #*
Camper's Date of Birth*

MonthDay Year
Date
Did the camper participate in the Fall 2022 Treats and Keeps Program*
Did/Will the camper participate in the 2023 Cookie Program*
What type of Health Insurance does your camper have?*

AmeriCareCareSourcePeachStateWellCare
Has your camper been to Girl Scouts of Greater Atlanta Camps in the past?*
What camp(s) has your camper attended*

Misty Mountain Overnight CampMeriwether Overnight CampTimber Ridge Day Camp
How many years has she attended?*

Step 3 - Parent/Household Information
Name of Parent/Guardian submitting the form*

P1 First Name P1 Last Name
P1 Parent/Guardian Date of Birth*

MonthDay Year
Date
P1 Email address of Parent/Guardian*
example@example.com
P1 Cell Phone for Parent/Guardian*
P1 Work Phone for Parent/Guardian
P2 Name of Parent/Guardian (if applicable)

P2 First Name P2 Last Name
P2 Date of Birth (if applicable)

MonthDay Year
Date
P2 Email address (if applicable)
example@example.com
P2 Cell Phone (if applicable)
P2 Work Phone (if applicable)
Address of Parent/Guardian submitting the form*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
County of Residence*

Step 4 - Household Income Verification
# of adults (over 18) living in your household*
# of children (under 18) living in your household*
Marital status of Guardian*
Are you or a family member a veteran or a member of the military*
Do you receive spousal support*
Amount of Spousal Support received monthly*
Do you receive child support?*
Amount of Child Support received monthly*
Do you receive Food Stamps?*
Amount of Food Stamps received monthly*
Do you receive other income?*
Source of other Income*
Amount of other income per month*
Due to a partnership with United Way of Greater Atlanta and the Department of Family and Children Services, we have been awarded a special grant to assist with out-of-school programming. To be eligible for ADDITIONAL funding for your child’s summer camp, please complete the PDF application below in full.

If your child currently receives one or more of the benefits or sevices under any of the programs listed below you will be eligible for additional assistance. You will need to complete the PDF document below and submit it.

Qualifying benefits or services:
- Temporary Assistance for Needy Families (TANF)
- Supplemental Nurtition Assistance Program (SNAP) (also known as Food Stamps)
- Medicaid or Social Security Income (SSI)
- Reduced or free lunch program at school - Note: This eligibility is only for single yourth eligibility. This is not applicatble if the entiire school population is awarded free lunch in universal eligibility.
- Peachcare for Kids
Please complete the form below for additional financial assistance if you meet the requirements noted above.
Complete the above form, save a copy, using the campers' last name and first name in the title, then upload it here with the required supporting documentation and submit it with your camp Scholarship request.

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