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?