Scholarship Application Form

Scholarship Application Form

For Summer Programs
Parent or Guardian's Name(s):*
Camper Name(s) and Camp(s) they are applying for:*
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Do you attend a church?*

YesNo
If so, what church?
Has your camper(s) been to one of our camps before?*

YesNo
If so, which camp and what year?
Has your camper(s) received a scholarship discount before?*

YesNo
What was the amount? $ amount What year? year
What impact do you hope that camp will have on your camper(s)?*
What are the specific circumstances that we should be aware of in considering your request?*
Total Household Size:   # Household *   Number of Dependents:   # Dependents*
Parent Occupation:   Occupation*   Income (before taxes):   $ Income*
Parent Occupation:   Occupation   Income (before taxes):   $ Income
Are you paying child support?*

YesNo
Are you receiving unemployment or disability pensions?*

YesNo
How much can you afford to pay for camp?*
Terms of Scholarship:
- Almost all the scholarships we award are partial.
- You will have to pay the camp deposit when you accept/register.
- Our scholarship offer will be sent via email and be good for 5 business days. If you do not accept, we will use the funds for another applicant.
- We require that within two weeks after the camp session, scholarship recipients / parents will submit a testimonial of their time at camp. Please email it to camps@palomar.camp and let us know how your child was impacted during their time at camp!
I agree to the terms.
Signature of Parent/Guardian*

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