Nancy "Two Feathers" Kuebler Scholarship Application Form
Trefoil Academy, LLC
Camper's Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
This camper:
*
Please Select
is brand new to Trefoil Academy, LLC
is new to this camp but has attended other Trefoil Academy, LLC affiliated events/camps/programs
is a returning camper.
Scholarship Amount Requested
*
The average range of what is awarded is between 1%-30% of tuition costs before taxes. Scholarships are not able to be applied to taxes, camp store, or credit card processing fees. The scholarship is only able to cover program/camp/event tuition only.
Family Information
Guardian 1
Parent Name
*
First Name
Last Name
Home Phone
*
Format: (000) 000-0000.
Work Phone
Format: (000) 000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Guardian 2 (if applicable)
Parent Name
First Name
Last Name
Home Phone
Format: (000) 000-0000.
Work Phone
Format: (000) 000-0000.
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Other children in the family
Please indicate any other children in the home:
Additional Information
Monthly Family Income (Gross)
*
Average Total Monthly Income
*
Please describe any additional exceeding circumstances that should be considered?
Any additional information you would like to let us know about?
If money is awarded, a customized payment plan will be developed. For the ease of your experience, what type of plan would you like us to set up for you?
*
Payment by credit card (the balance split over two months)
Payment by credit card (the balance split over three months)
Payment plan by credit card (the balance split over four months)
By check
Before any scholarship money is able to be awarded, we will need to receive a registration form. Once the camp registration form has been received, you will be notified within 1 week of the results.
*
I understand the next step
Guardian Signature
Continue
Continue
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