2019_Financial Aid Application
(First and Last)
Name of Primary Income Provider
Relation to Student
Name of Employer
Number of Years at Present Job
Net Monthly Income
Estimated Monthly Expenses
Net Yearly Income in 2018
If yes, what kind?
Amount Can Contribute
If you are not receiving assistance but still believe that you have financial hardships or extenuating circumstances (permanent or temporary) that qualify your child for a financial aid packet, please explain these hardships.
Information for Registration
If you have already registered online and reserved your spot with the $100 deposit, you do not need to answer the following questions.
(First and Last)
What is your student's date of birth?
Student's grade in the fall of 2019
Which school does your student currently attend?
How does your student identify their gender?
Decline to State
Primary guardian's relation to student
Primary guardian's street address
Please include city, state, and zip code
Primary guardian's email
Primary guardian's phone number
Secondary guardian's name.
(First and last)
Secondary guardians phone number
Secondary guardian's email address
Emergency Contact Name
Emergency Contact Relation
Emergency Contact Phone
Please list all medications your student is currently taking.
Please describe all medical conditions or behavioral concerns we should be aware of. Please make sure to note any allergies.
May we administer over the counter pain medications to your student?
May your student sign themselves out at the end of the day?
If the answer is no, please list any adults able to sign them out with a Camp Coordinator
Is there anything else we should know about your student?
Send me a copy of my responses
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