Camps and Academy Application
First Name:
*
Last Name:
*
Preferred Email Address
Personal
Alternate
Personal Email:
Alternate Email (for example, your parent's email):
Primary Address Street:
*
City:
*
State:
*
Zip Code:
*
County:
*
Preferred Phone Number Type
Home
Cell
Home Phone Number:
Cell Phone Number:
Date of Birth:
School Lunch Status
Free
Reduced
Full Price
High School Graduation Year:
I am...
*
in 7th grade and would like to apply for Camp New Beginnings.
in 8th-12th grade and would like to apply for Camp Steele.
I am in:
*
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
Who do you currently live with?
Parent/Guardian Full Name:
Parent/Guardian Primary Phone Number:
Parent/Guardian Primary Alternate Phone Number:
Parent/Guardian Email:
Parent/Guardian Occupation:
Parent/Guardian Highest Education Level:
Pre-High School
Some High School
High School Diploma/GED Certificate/Associate's Degree Bachelor's Degree
Advanced Degree
Unknown
2nd Parent/Guardian Full Name:
2nd Parent/Guardian Primary Phone Number:
2nd Parent/Guardian Alternate Phone Number:
2nd Parent/Guardian Email:
2nd Parent/Guardian Occupation:
Parent/Guardian Highest Education Level:
Pre-High School
Some High School
High School Diploma/GED Certificate/Associate's Degree Bachelor's Degree
Advanced Degree
Unknown
What do you know about High Rocks? Why do you want to be a part of it?
*
What are your three best qualities? Why?
*
What would you like to change and/or work on about yourself? Why?
*
Tell us about a dream you have for yourself or your community, school or world.
*
What is something many people don't know about you and would be surprised to learn?
*
Write about a person who has inspired you and why. How has the example they have set helped change the way you live your life? (about 250-750 words)
*
RECOMMENDATION FORM
You need to ask someone (no parents or relatives) to submit an online recommendation form for you. You can ask a teacher, coach, pastor, community leader, or another person who knows you well. Please list the NAME, RELATIONSHIP, and PHONE NUMBER of the person you plan to have complete this recommendation form for you that we can contact if we have questions.
Find an online recommendation form at:
https://form.jotform.com/70585323103145
Name:
Phone Number:
Email
example@example.com
Relationship to you:
*
Submit
Should be Empty: