Camp Scholarship Form

Camper Scholarship Form

Please take a moment to fill out the form.

Parents or Guardian's Name(s)

Camper's Full Name

Birthday

Phone

Address

Camp Name/Dates your camper is hoping to attend

Cost of Camp Program?

Name of home Church?

With whom does the camper primarily reside?

Occupation of primary income provider?

Total monthly household income?

Number of persons in household?

If yes, from whom?

Please provide a statement of why you would like you child to attend YAA Camp?

Please provide a statement regarding your current financial condition.

Your Signature

Select a date

Thanks for submitting!