2026 Envision Summer Camp Scholarship Application Form
Student's Full Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Grade during 2025-2026 School Year
Homeroom Teacher
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Parent Information
Parent's Name
First Name
Last Name
Phone Number
*
Phone Number
Parent's Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Please select the camp you would like to attend
Please Select
University of Houston
Rice University
Recommend a camp for consideration that is not currently listed
Provide camp name, website and/or contact information
Why are you interested in attending summer camp?
How will you use your camp experience to encourage others to try new things?
PARENTAL COMMITMENT
As the parent of the student listed above, I understand that it is my responsibility to make the necessary arrangements to ensure that my child attends the camp for which he/she receives a scholarship. I understand that I will be responsible for reimbursing Envision for the cost of the camp if my child fails to attend and I do not contact Envision at least 30 days prior to the start of camp so that another deserving student can be selected to attend.
*
I hereby grant Envision permission to use my child's likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration.
*
Signature
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