Clone of Scholarship Request

Parent/ Guardian Name

First NameLast Name
How Many Campers?
Camper Name*

First NameLast Name
Camper Name

First NameLast Name
Camper Name

First NameLast Name
Camper Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
E-mail
example@example.com
Questions and Details:
Why are you requesting a scholarship?
Have you contacted your church about help paying for camp?

YesNo
How much are you requesting as a scholarship? (Per child)

$25$50$100Other
Type a question
Camper Name *

First NameLast Name
Should be Empty: