Camp Scholarship Form - Cincinnati Church

Camp Scholarship Application

Name of Parent(Required)

First Last

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Camper Information (Please use one form per child if applying for multiple children)(Required)

First Last

Age(Required)

Camp Attending(Required)

Has the child attended camp with the church before?(Required)

If yes, how many years?

Was this child sponsored by this Scholarship program last year?(Required)

Have you already registered your child for camp?(Required)

Did you pay a deposit when you registered your child?(Required)

If yes, how much?

Amount of assistance you are requesting(Required)

Reason Scholarship is needed:(Required)

I certify that the information contained in this application is accurate and true.(Required)

Electronic signature - Parent's Full Name

Date