FINANCIAL APPLICATION - 2010 Season

We will NOT process your application unless it is completed in full.
If it is not applicable to you, please write "None".
Only one scholarship application necessary per family.

Your scholarship application will not be processed unless you have already submitted a camper application for our summer 2010 season.

Family Information Last Name:
Father's Name:
Mother's Name:
Address:
City:
State:
Zip:
Country:
Home Phone:
Cell Phone:
Father's Email:
Mother's Email:
Number of people in Household : A value is required.Invalid format.The entered value is greater than the maximum allowed.Exceeded maximum number of characters.

Please list their names and ages below:

Exceeded maximum number of characters.

Any further information that you'd like to tell us?

Financial Information Is Father currently employed? yes no

Name of Company:
Father's Position:
MONTHLY NET EARNINGS ($): Invalid format.

Is Mother currently employed? yes no

Name of Company:
Mother's Position:
MONTHLY NET EARNINGS ($): Invalid format.

TOTAL MONTHLY INCOME ($): A value is required.Invalid format.

Financial Assistance

DO YOU GET ASSISTANCE FROM ANY OF THE FOLLOWING?
If yes, please enter the MONTHLY AMOUNT.

Public Assistance/Welfare yes no

Public Assistance Amount ($): Invalid format.

Public Assistance/Welfare Case #:

Food Stamps: yes no

Food Stamps Amount ($): Invalid format.

Food Stamps Case #:

Section 8: yes no

Section 8 Amount ($): Invalid format.

SSI yes no

SSI Amount ($): Invalid format.

Social Security yes no

Social Security Amount ($): Invalid format.

NYANA: yes no

NYANA Amount ($): Invalid format.

Pension: yes no

Pension Amount ($): Invalid format.

Other: yes no

Amount ($): Invalid format.

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