Scholarship Application

Scholarship Application
It is our wish that every child can experience a week of camp! We understand that at times money can obstruct this and so we want to help you find a way to send your kids to camp. Many donors have graciously made a way possible! We ask that you help us stretch these funds as much as possible. Before applying, please find out if your local church or family members are willing to help you in any way.

Then, fill out the information below by June 1st AND send a copy of your most recent IRS 1040 to office@bayouca.com with your name clearly attached. We will process your application and notify you of your scholarship amount. All scholarship amount will be based on income eligibility.
How many campers are you looking to send to camp?
Campers Name

First NameLast Name
Week applying for
Find camp week dates on our website bayouca.com/kids-camp
Campers Name

First NameLast Name
Week applying for
Find camp week dates on our website bayouca.com/kids-camp
Campers Name

First NameLast Name
Week applying for
Find camp week dates on our website bayouca.com/kids-camp
Campers Name

First NameLast Name
Week applying for
Find camp week dates on our website bayouca.com/kids-camp
Campers Name

First NameLast Name
Week applying for
Find camp week dates on our website bayouca.com/kids-camp
Parent/Guardian Name(s)

First NameLast Name
2nd Parent/Guardian

First NameLast Name
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Do you attend a church? If so, which one? *
Include city
Has your church been informed of the child's need?*

YesNo
How much are they able to assist per camper?*
How many people are in your household?*
Wage earner 1 occupation title/job title*
Wage earner 1 Yearly Income*
Wage earner 2 occupation title/job title
Wage earner 2 Yearly Income
Additional Household Income Amount per year?*
Including alimony, child support, social security, disability, public assistance, etc.
How much are you able to provide towards each camper's fee?*
Please feel free to add any additional information below.
Parent/Guardian Signature

Clear
Should be Empty:

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