SCNS Scholarship Application Form

SCNS Scholarship Application Form

Thank you for your interest in Sussex County Nature School Summer Camp! We are pleased to offer scholarships to families in need of financial assistance to help make the camp experience accessible to all. Please complete the form below to apply for a scholarship. Please complete one form per child.
PERSONAL DATA

Please fill out personal information of the legal parent/guardian.
Primary Parent/Guardian's Full Name*

First NameMiddle NameLast Name
Birth Date*

MonthDayYear
Secondary Parent/Guardian's Full Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Child's Full Name*

First NameMiddle NameLast Name
Child's Birth Date*

MonthDayYear
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
E-mail*
example@example.com
Financial Assistance
Reason for requesting financial assistance (please provide details on why you are seeking help for camp fees):*
Do you need help covering any of the following additional items for camp (please check all that apply)?

SnackLunchWeather-appropriate clothing (e.g., rain gear, sun protection)Other

Documentation for Financial Assistance (Optional but Recommended)

To help us assess your need for assistance, please attach one or more of the following documents: a copy of your most recent pay stubs, a copy of your most recent tax return (or proof of self-employment), documentation showing participation in public assistance programs (e.g., SNAP, Medicaid), any additional documentation you believe is relevant to your application. All submitted documents will remain confidential and will only be used for the purpose of reviewing this scholarship application.
File Upload

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Other Information
How did you hear about the scholarship opportunity?
Is there any additional information you would like to share with us about your application or your child’s needs?*

Consent and Signature

I certify that the information provided in this application is accurate to the best of my knowledge. I understand that the scholarship committee will review this information and that my application will be kept confidential.
Parent/Guardian Signature:*

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Date*

MonthDayYear
Date
Should be Empty:

Financial Assistance