SCHOLARSHIP APPLICATION

Camper Name

First

Last

Parent/Grandparent/Guardian Name

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Camp Name

Camp Session Dates

Has Camper Already Registered?

Amount Church Can Provide

If applicable

Scholarship Request Amount

Lutherans Outdoors can provide scholarships up to half of the fee for summer camp. Please contact your church if you need additional assistance.

Home Church

If applicable

Camper Camper Phone

Additional Information

Agreement

I certify that the above information has been completed to the best of my knowledge.