2024 ARTx3 Summer Campus Scholarship Application

2024 Summer Camp Scholarship Application

Please complete 1 form for child. All information is strictly confidential
Student Name*

First NameMiddle NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Email
example@example.com
Student's Phone Number
Birth Date*

MonthDayYear
Rising Grade*
What do you hope your child will gain from this experience.*
Parent or Guardian's Name*

First NameLast Name
Parent Or Guardian's Phone Number*
Please enter a valid phone number.
Parent or Guardian's Email*
example@example.com
Parent or Guardian Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact*

First NameLast Name
Emergency Contact Phone*
Please enter a valid phone number.
FINANCIAL INFORMATION

Eligibility for scholarships is based on financial need, including household size and household income. Household includes all people (adults and children) living in the household. Please indicate your total annual household income from all sources (please attach 2023 tax forms showing.
Adjusted Gross Income for all earners in household:*

Below $20,000$20,001-$35,000$35,001-$50,000$50,001-$65,000Over $65,000
Number of people in household (adults)*
Number of people in household (children under 18)*
Total camp fees (for child on this scholarship application)
Amount you are requesting (for child on this scholarship application)
Total ASC camp fees for all children in household:
What camp(s) is your child wanting to enroll in?*

Art Jr. CampArt Pro CampTheater Jr. CampTheater Pro CampSpace Camp: Center of GravityEngineering Graphics CampHip-Hop CampPoetry Camp
Should be Empty:

2024 Summer Camp Scholarship Application

FINANCIAL INFORMATION