Program Scholarship Application

Scholarship Application
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2025 Summer Program Scholarships are Now Closed and Will Reopen for 2026 in the Fall

This Application is Still Open for All Other Programs
Scholarships are designed to enable as many children as possible to have a KSS program experience by providing financial assistance to families with demonstrated financial need

Please review the KSS Scholarship webpage for more details about the application process and guidelines for receiving a scholarship. If you need assistance filling out the application or have questions you can also contact us at (970)468-2098 or Support@KeystoneScienceSchool.org.
Family Information
Primary Parent/ Guardian Name*

First NameLast Name
Primary Parent/ Guardian Phone Number*
Primary Parent/ Guardian Email*
example@example.com
City of residence*
State of residence*
Primary language spoken in the home*
Total number of children in the household*
Total number of adults in the household*
Financial Information
Does your family qualify for any of the following federal or state-based assistance?*
Please select the income range of your household*
In detail, please explain why financial aid is necessary for your family. Include relevant information about your current employment status and your financial situation. *
Childcare & Outcomes
If my child was not in this program they would have these care options (select the most likely option)

At home aloneWith a sibling 10 years old or youngerWith a sibling 11 years old or olderAt work with a parentAt home with an adult family memberWith a baby sitterAt another programOther
What do you and your child hope to gain from this KSS experience?*
Please let us know if there is any additional information you would like us to know about your application
Participant Information
How many children are you applying to a scholarship for?*
What is your participant(s) ethnicity?
Do your participant(s) attend school in the Summit School District?*

YesNo
Participant 1
1: Participant Name*
1: What grade will they be in fall 2025?*
1: Gender Identity*
1: What program are you applying for?*

Day Camp (For K-5th graders in summer)Pathfinders (For 6th-8th graders in summer)Discovery Camp (For 1st-8th graders in summer)Counselor Assistant Program (For 8th -12th graders in summer)Adventures (For 5th-12th graders in summer)Girls in STEM ( For 4th-8th graders in fall, winter, and spring)Harvest Camp (For K-12th graders in fall)H2O Outdoors (For 9th-12th graders in fall)Other
1: Desired Sessions (exact dates are program dependent):

Session 1: 6/9/25-6/14/25Session 2: 6/16/25-6/21/25Session 3: 6/23/25-6/28/25Session 4: 6/30/25-7/3/25Session 5: 7/7/25-7/12/25Session 6: 7/14/25-7/19/25Session 7: 7/21/25-7/26/25Session 8: 7/28/25-8/2/25Session 9: 8/4/25-8/9/25Session 10: 8/11/25-8/16/25Session 11: 8/18/25-8/22/25
1: Has the participant previously attended KSS programs?*
Participant 2
2: Participant Name
2: What grade will they be in fall 2025?
2: Gender Identity
2: What program are you applying for?

Day Camp (For K-5th graders in summer)Pathfinders (For 6th-8th graders in summer)Discovery Camp (For 1st-8th graders in summer)Counselor Assistant Program (For 8th -12th graders in summer)Adventures (For 5th-12th graders in summer)Girls in STEM ( For 4th-8th graders in fall, winter, and spring)Harvest Camp (For K-12th graders in fall)H2O Outdoors (For 9th-12th graders in fall)Other
2: Desired Sessions (exact dates are program dependent):

Session 1: 6/9/25-6/14/25Session 2: 6/16/25-6/21/25Session 3: 6/23/25-6/28/25Session 4: 6/30/25-7/3/25Session 5: 7/7/25-7/12/25Session 6: 7/14/25-7/19/25Session 7: 7/21/25-7/26/25Session 8: 7/28/25-8/2/25Session 9: 8/4/25-8/9/25Session 10: 8/11/25-8/16/25Session 11: 8/18/25-8/22/25
2: Has the participant previously attended KSS programs?
Participant 3
3: Participant Name
3: What grade will they be in fall 2025?
3: Gender Identity
3: What program are you applying for?

Day Camp (For K-5th graders in summer)Pathfinders (For 6th-8th graders in summer)Discovery Camp (For 1st-8th graders in summer)Counselor Assistant Program (For 8th -12th graders in summer)Adventures (For 5th-12th graders in summer)Girls in STEM ( For 4th-8th graders in fall, winter, and spring)Harvest Camp (For K-12th graders in fall)H2O Outdoors (For 9th-12th graders in fall)Other
3: Desired Sessions (exact dates are program dependent):

Session 1: 6/9/25-6/14/25Session 2: 6/16/25-6/21/25Session 3: 6/23/25-6/28/25Session 4: 6/30/25-7/3/25Session 5: 7/7/25-7/12/25Session 6: 7/14/25-7/19/25Session 7: 7/21/25-7/26/25Session 8: 7/28/25-8/2/25Session 9: 8/4/25-8/9/25Session 10: 8/11/25-8/16/25Session 11: 8/18/25-8/22/25
3: Has the participant previously attended KSS programs?
Participant 4
4: Participant Name
4: What grade will they be in fall 2025?
4: Gender Identity
4: What program are you applying for?

Day Camp (For K-5th graders in summer)Pathfinders (For 6th-8th graders in summer)Discovery Camp (For 1st-8th graders in summer)Counselor Assistant Program (For 8th -12th graders in summer)Adventures (For 5th-12th graders in summer)Girls in STEM ( For 4th-8th graders in fall, winter, and spring)Harvest Camp (For K-12th graders in fall)H2O Outdoors (For 9th-12th graders in fall)Other
4: Desired Sessions (exact dates are program dependent):

Session 1: 6/9/25-6/14/25Session 2: 6/16/25-6/21/25Session 3: 6/23/25-6/28/25Session 4: 6/30/25-7/3/25Session 5: 7/7/25-7/12/25Session 6: 7/14/25-7/19/25Session 7: 7/21/25-7/26/25Session 8: 7/28/25-8/2/25Session 9: 8/4/25-8/9/25Session 10: 8/11/25-8/16/25Session 11: 8/18/25-8/22/25
4: Has the participant previously attended KSS programs?
Participant 5
5: Participant Name
5:What grade will they be in fall 2025?
5:Gender Identity
5: What program are you applying for?

Day Camp (For K-5th graders in summer)Pathfinders (For 6th-8th graders in summer)Discovery Camp (For 1st-8th graders in summer)Counselor Assistant Program (For 8th -12th graders in summer)Adventures (For 5th-12th graders in summer)Girls in STEM ( For 4th-8th graders in fall, winter, and spring)Harvest Camp (For K-12th graders in fall)H2O Outdoors (For 9th-12th graders in fall)Other
5: Desired Sessions (exact dates are program dependent):

Session 1: 6/9/25-6/14/25Session 2: 6/16/25-6/21/25Session 3: 6/23/25-6/28/25Session 4: 6/30/25-7/3/25Session 5: 7/7/25-7/12/25Session 6: 7/14/25-7/19/25Session 7: 7/21/25-7/26/25Session 8: 7/28/25-8/2/25Session 9: 8/4/25-8/9/25Session 10: 8/11/25-8/16/25Session 11: 8/18/25-8/22/25
5: Has the participant previously attended KSS programs?
Please note:
- Some data and information will be included in grant reports. Personal identification will not be shared in this process.
- All financial information on this form is confidential and is used exclusively by Keystone Science School and a committee of volunteers to assess scholarship eligibility.
- If a child is awarded a scholarship, the recipient will be asked to write about his/her experience so we can share this with our donors. Names will be kept confidential at all times.
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Scholarship Application

Family Information

Financial Information

Childcare & Outcomes

Participant Information

Participant 1

Participant 2

Participant 3

Participant 4

Participant 5