WinShape Hartsville Scholarship Application

WinShape Hartsville Scholarship Application
Camper Information
Email
example@example.com
Campers Birthdate

MonthDayYear
Date
Campers Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Name

First NameLast Name
Phone Number

Area CodePhone Number
5k1st grade2nd grade3rd grade4th grade5th grade
Select Your Household Income
$50 off (you pay $130)Half Scholarship (you pay $90)Full Scholarship (you pay $0)Other
All scholarship applications are reviewed by a review committee before any funds can be approved for scholarship use. Scholarships are assigned on a first-come, first-served basis, until all funds have been allocated. SUBMITTAL OF THIS FORM DOES NOT CONSTITUTE A PROMISE OF A SCHOLARSHIP. YOU WILL BE CONTACTED IF A SCHOLARSHIP IS AVAILABLE.
Parent Signature*

Clear
Should be Empty: