YOUTH CAMP 2024
Scholarship Application
Application Date:
*
-
Month
-
Day
Year
Full Name of Applicant:
*
First Name
Middle Name
Last Name
Full Name of Spouse:
First Name
Middle Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email:
example@example.com
Contact Number:
*
I attend:
*
Life Church Allentown
Life Church Bethlehem
Life Church Center Valley
Life Church Easton
Life Church Macungie
Life Church Nazareth
Life Church Reading
Have you previously received financial assistance from us before?
blanks
If so, when?
blank
Brief description of your current needs: Including specific type of assistance need and the amount.
Number of Children in your household attending camp?
Please list the name, age and grade of each student:
Student Name
Age
Grade
1
2
3
4
Submit Application
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