Dave Prowitz Memorial Scholarship Application
Complete the short application to request financial assistance.
Camper name
*
First Name
Last Name
Parent Name
*
First Name
Last Name
Email address
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Number of people in your household
*
What is your approximate annual household income?
*
Under $25,000
$25,000–$49,999
$50,000–$74,999
$75,000 or more
Prefer to discuss this with the camp team
We may ask for documentation to verify income. All information is kept confidential.
Many churches love to help send kids to camp. This just helps us find every dollar we can for your family.
Do you currently have a home church?
*
Yes
No
What is the name of your home church?
*
Where is your home church located (City, State)
*
Select One
I've asked my church to help scholarship my camper and they have agreed to provide financial assistance.
I've asked my church to help scholarship my camper and they are unable to provide financial assistance.
I have not yet asked my church for assistance.
Select One
I authorize Timber-lee to contact a church in my area about financial assistance on my behalf.
I prefer not to ask a church for financial assistance.
Please tell us about any extenuating circumstances related to your financial need which have contributed to your need for a scholarship.
Submit Application
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