Scholarship Application Form

Dear Parent/Guardian,

Through the generosity of dedicated donors, Pleasant Hill Outdoor Camp is able to set aside funds specifically for the purpose of camper scholarships. We believe that the summer camp experience is one of the most valuable experiences a child can have, and we believe every child to experience "Summer's Best Adventure!" regardless of their ability to pay.

Please answer the following questions completely so we can determine the maximum scholarship amount your family is eligible for. Applications will be reviewed in a timely manner and will be awarded based on the needs of the registered camper(s). Please make sure your camper is registered and you make a minimum payment of $50 to secure your camper's spot for this upcoming summer. You will be notified once a decision is made.

*Please note scholarships are not awarded to cover additional charges, such as Horselovers' programming or Camp Store funds.

Steps for Camp Scholarships

1. Complete Camper Registration:
- Visit the registration portal and complete your camper's registration. Provide all required information including camper details, emergency contacts, medical information, etc. Make sure to complete the forms. At the end, you can click, that you are applying for a scholarship.

2. Payment of Minimum $50 Deposit:
- Pay a minimum deposit of $50 to secure your camper's spot. This payment is typically required to reserve the spot and initiate the registration process.

3. Fill Out Scholarship Application:
- Fill out and complete the scholarship application completely, providing accurate information about your financial situation and any other required details.

4. Await Response:
- Wait for a response from the camp regarding the scholarship application.

5. Confirmation of Acceptance:
- If your child is awarded the scholarship, confirm your acceptance within 7 business days as per the camp's instructions. Without a response, the scholarship may be awarded to another applicant. Upon acceptance, the scholarship amount will be added to your camper's account.

6. Payment of Remaining Balance:
- Pay any remaining balance by the specified deadline (June 1st) unless alternative arrangements have been made. This may include paying the remaining camp fees after deducting the scholarship amount.

8. Enjoy Camp!:
- Once the registration process is complete and any remaining fees are paid, your child is all set to enjoy their camp experience! Prepare them for an exciting and memorable time at camp.

Your Name*

First NameLast Name

Your Relationship to Camper*

Your Phone Number*

Area CodePhone Number

Alternative Phone Number

Area CodePhone Number

Camper's Address (We will use this to verify the camper within our registration system)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Your Email Address*

example@example.com

Has the camper ever attended camp at Pleasant Hill Outdoor Camp before?*

YesNo

Has the camper ever received scholarship assistance from PHOC before?

YesNo

Check the reason(s) for why you are applying for a scholarship?*

Low Income or Financial Hardship (e.g. loss of employment)Familial Circumstances (Single-parent households,large households, death in the family, divorce or separation, etc.)Expensive Medical ExpensesUnexpected CircumstancesLoss of housingReceives Governmental AssistanceLow Take Home PayOther

Please briefly explain below.*

Please enter the Camper information below. Please use their full name and how it shows on their registration. We routinely only give out 1 scholarship per camper/per season, if you want to send your camper(s) multiple weeks and possibly receive aid for those weeks- put their name down as many weeks you want them to attend. Receiving multiple scholarship is rare, but you are welcomed to inquire. e.g. if you want your child to receive two scholarships for two different terms, you would put their name down twice(Also, make sure you register them for that week on our registration software as well).*

	First Name	Last Name	Age
Camper 1
Camper 2
Camper 3
Camper 4

Are you asking for a scholarship for more than 4 children?*

YesNo

Please enter the Campers' information below. Please use their full name and how it shows on their registration. If you have more campers you are applying for scholarships for please contact the office at info@phoc or call at 419-938-3715*

	First Name	Last Name	Age
Camper 5
Camper 6
Camper 7
Camper 8

Does a child within the household have an incarcerated parent?

YesNo

We believe that every camper should have the opportunity to experience and embrace the amazing love of Jesus. How much are you willing to contribute towards the total costs of your camper(s)?*

To access your Form 1040, which is the standard U.S. individual income tax return form, you have a few options:

1. Online Access (IRS Website)
- You can access and download Form 1040 directly from the IRS website. Visit www.irs.gov and navigate to the "Forms & Instructions" section. From there, you can search for Form 1040 and download the PDF version.

2. Tax Preparation Software:
- If you used tax preparation software like TurboTax, H&R Block, or TaxAct to file your taxes, you should be able to access your completed Form 1040 through your account on their respective websites. Log in to your account and navigate to your filed returns to view and download your Form 1040.

3. Tax Preparer:
- If you used a tax preparer (such as a Certified Public Accountant or tax professional) to file your taxes, they should provide you with a copy of your completed Form 1040. You can contact them to request a copy if you don't already have it.

4. IRS Transcript:
- You can request a transcript of your tax return from the IRS. This transcript typically includes most line items from your tax return, including Form 1040. You can request transcripts online through the IRS website or by mail.

Remember, accessing your tax return may require providing personal information for verification purposes. Always ensure you're accessing your tax documents through secure channels. If you did not file a 1040 please contact info@phoc.org.

Please upload a copy of your (or the family's) most recent 1040 . *

Browse Files

Please read and check each box:*

I understand that Pleasant Hill Outdoor Camp may offer specific weeks for scholarship depending on session availability.I understand that the completion of this application does not guarantee the award of scholarship dollars.I understand that neither Camp Store monies nor trail rides are included in the scholarship award.I certify that all information on this form is true and that all income is reported. I understand that this information is being given for the receipt of Federal funds. I understand that SFSP officials may verify the information. I understand that if I purposely give false information, the participant receiving meals may lose the meal benefits, and I may be prosecuted.

Signature

Application for Scholarship Assistance