Fixing Father's Summer Camp Support Grant
Summer 2025
Child's Name
*
First Name
Last Name
Male / Female/Other
Male
Female
Other
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
Email
*
example@example.com
Last Year Completed in School
What week of camp will you be attending?
June - July 2024
July - August 2024
Summer Camp Information
What is the name of the summer camp?
*
What is the address of the summer camp?
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Dates Summer 1
Dates Summer 2
Dates Summer 3
File Upload: Proof of Paid Session 1 Enrollment
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Dates Summer 2
What is the cost for summer camp? (Summer 1)
What is the cost for summer camp (Summer 2)
What is the cost for summer camp (Summer 3)
Parent / Guardian Information
Parent / Guardian Name
*
First Name
Last Name
What is your occupation / job title?
*
What is the combined/total annual household income: Check the appropriate box.
Under $20,000
$20,000-$30,000
$30,000-$40,000
$40,000 and Up
Income
Do you have other children attending this camp (Gold Dragons Only) this year? If yes, click yes and fill out an addtional form for the addtional child.
*
Yes
No
Submit
Should be Empty: