Campership Application Form
Please answer all questions (those not applicable, please use N/A)
Name of Parent/Guardian (1)
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
*
Please enter a valid phone number.
Work
*
Please enter a valid phone number.
Cell/Other
Please enter a valid phone number.
Email
*
example@example.com
Name of Parent/Guardian (2)
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
*
Please enter a valid phone number.
Work
*
Please enter a valid phone number.
Cell/Other
Please enter a valid phone number.
Email
*
example@example.com
Check Proper Category
*
Both parents working
One parent working
Unemployed
Self-Employed
With whom does the child live?
*
Name of Parent/Guardian (1)
*
First Name
Last Name
Occupation
*
Self-Employed
*
Yes
No
Place of employment/Address
*
Phone Number
*
Please enter a valid phone number.
Name of Parent/Guardian (2)
*
First Name
Last Name
Occupation
*
Self-Employed
*
Yes
No
Place of employment/Address
*
Phone Number
*
Please enter a valid phone number.
Name(s) of others living in the home
*
Campership Applicant Information
Camper's Full Name
*
First Name
Last Name
Age
*
Name of Camp/Contact Information
*
Cost of Camp Program ($)
*
Camper's Full Name
First Name
Last Name
Age
Name of Camp/Contact Information
Cost of Camp Program ($)
Registration Cost/Subsidy Awarded from the Camp Scholarship Fund:
*
Registration Cost Amount Household is paying:
*
Other sources of funding obtained (i.e., family, friends, church, clubs):
*
How much is being requested from JFS:
*
Financial Information
Please upload/submit proof of all forms of income for all household members 18 yrs. of age and older, see File Upload at the bottom of form.
Monthly Gross Income
*
Total Monthly Household Expenses
*
Please provide any additional information which you feel to be important when we are considering your application:
Please provide an essay as to how the camper would benefit from the camp experience/ why they would like to attend (feel free to attach additional paper as needed):
*
Signature of Parent/Guardian
*
Date
*
-
Month
-
Day
Year
Date
File Upload: Please submit proof of all forms of income for all household members 18 yrs. of age and older (include 2 most current months of paystubs, cash aid notice of action, alimony support, SSI, SSA, SSDI, receipts for cash payment for employment, copy of current 1040 tax return, copies of ID’s for parent(s) and camper.
*
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