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Camp Scholarship Application

Please print this form, fill it out and either email it to the church office
or mail it to Memorial UCC, 5705 Lacy Rd., Fitchburg WI 53711, Attn: Trustees.
It is due by May 1st of the camp year.

Applicant’s name _____________________________________________

What grade will you be in school next year? ___________________________

Parent’s name _______________________________________________


Home phone number _________________________________________

Have you received a camp scholarship in previous years? ___ Yes ___No

What camp are you interested in attending?__________________________

What are the dates of the camp you are interested in? _____________________

Registration cost of camp _____________________

Write a short paragraph indicating
(a) Why you want to attend a church camp?
(b) What you expect to gain from camp?
(c) What you can bring back to your church or community from things learned and enjoyed at camp?