Summer Camp VBS Scholarship Application Form
(July 6 - July 10, 2026, 09:00AM - 3:30PM) Free Daily Lunch & Snacks Provided - Ages: SK-Gr.6(2020-2014)
Child's Full Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Child's Gender
Male
Female
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Family Information
Parent 1
Parent Name
First Name
Last Name
Home Phone
Format: (000) 000-0000.
Work Phone
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent 2
Parent Name
First Name
Last Name
Home Phone
Format: (000) 000-0000.
Work Phone
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Other children in family
Configurable list
*
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Additional Information
Monthly Family Income (Gross)
$
Total Monthly Income
Please Explain the Reasons for Need
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Questions? Contact : tkpc.cedum@gmail.com
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