Scholarship Application

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* Denotes required field

Camper's First Name

Camper's Last Name

Camper's Date of Birth

For which service are you seeking a scholarship?

Summer Camp

Mini Camp

After School

Camper Age

Annual Household Income

Household Size

This information will only be seen by our administrative team.

Parent/Guardian First Name

Cell Phone

Parent/Guardian Last Name

Parent/Guardian Email

Home Phone

Work Phone