Scholarship Application

Name of camper(s)

Has camper(s) attend Neotez in previous years?

Desired session of camp to attend:

Senior High (grades 9-12) June 9

Pre-Camp (grades K-2) June 16

Middle School (grades 6-8) June 23

Boys' Week (grades 3-5) July 7

Girls' Week (grades 3-5) July 14

All Teen (grades 6-12) July 21

Parent/Guardian Name

Parent/Guardian Phone

Parent/Guardian Email

Address

Street

Address

City

State/Province

Zip/Postal

Brief explanation of financial needs:

Is scholarship support available from your local church?

Yes

No

I don't know

Name of a contact at your local church (minister, youth leader, elder, Camp representative):

Contact's Phone

Contact's Email

Amount you are able to pay:

$60

Other Other

Please complete all information. If unable to complete online, please print and mail completed scholarship form to campneotez@gmail.com.

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