HOOPS4LIFE CAMP FEE ASSISTANCE APPLICATION
Name of Parent
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Camper 1
*
First Name
Last Name
Grade of Camper 1 Next Fall
Name of Camper 2
First Name
Last Name
Grade of Camper 2 Next Fall
Name of Camper 3
First Name
Last Name
Grade of Camper 3 Next Fall
Are the campers on free/reduced lunch program at school?
*
Yes
No
Session(s) for Which I Am Seeking Financial Assistance:
*
West Seattle Session 1 (June 24-28)
West Seattle Session 2 (July 8-12)
West Seattle Session 3 (July 22-26)
West Seattle Session 4 (August 5-9)
Total amount I would prefer to contribute towards camp tuition for the session I am seeking assistance for (we will ask for a minimum amount that will help cover the costs for each camper)
*
As unintrusively as we can make it for you, please explain why you are submitting the request for financial assistance (any information you provide will be reviewed by camp scholarship committee only and will remain confidential).
*
Submit
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