Summer Camp Scholarship Application

Deadline to submit this form is May 30, 2026

The purpose of this application form is to award one child or student a scholarship for one week of summer camp.

Student Information

Name

Age

Camp(s) applying for

Camp Session

Parent Information

Name

Phone

Financial Information

Household Size

Annual household income (approximate)
(please select the range that best applies)

Comments

Scholarship Request

Amount Requested

Received scholarship previously

Student Impact Statement

Parent Signature

All information submitted will be used solely for scholarship review purposes and will not be shared outside of program administration.