Camper Scholarship Application

Camper's Full Name*

Camper Age*

Sex*

Female
Male

School (2022-2023 school year)

School Grade (2022-2023 school year)*

Parent 1 Full Name*

Parent 2 Full Name

Home Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Parent 1 Phone*

Parent 2 Phone

Parent 1 Email*

Parent 2 Email

Parent 1 Occupation*

Parent 2 Occupation

Parent 1 Annual Gross Income*

Parent 2 Annual Gross Income

In addition to your household income, does your family receive any additional financial support (ex. child support)?

Additional Income*

Yes
No

Additional Income Amount per Month

Is Camper living with both parents?*

Yes
No

If not, with whom?

Number of Children in Family*

Number of Children applying for a Scholarship*

Number of Years Applicant has attended Olympia*

How did you hear about Camp Olympia?

Has Applicant previously applied for a Camp Olympia scholarship?*

Yes
No

Has Applicant previously received a Camp Olympia scholarship?

Yes
No

Please list any family members of the Applicant who have previously attended Camp Olympia summer camp.

List 5 words that describe the Applicant.*

Has the Applicant attended any other residential summer camps?*

Yes
No

If yes, which summer camp(s)?

Has the Applicant had any behavioral or conduct issues at school, other camps, etc.?*

Yes
No

If yes, please explain:

Each scholarship applicant family is expected to contribute a portion of the camper tuition to help offset the costs of the camper attending Camp Olympia. Please note that full tuition for a 2-week term is $4,450 and 3-week term is $5,575.

How much will you contribute to the cost of the camp tuition for the Applicant?*

Would anyone else contribute to the cost of the camp tuition?*

Yes
No

If yes, how much do you expect this other source to contribute?

Note: Reference(s) must be completed by a NON-FAMILY member.

Reference will be submitted from:*

Below is a list of the Camp Olympia 2023 Summer Camp Term Dates in which scholarships may be available. Please note that availability for scholarships varies within each term.

First Choice of Summer Term*

Second Choice of Summer Term

Third Choice of Summer Term

Please sign below that you, as Parent of the Applicant, want Camp Olympia to consider the Applicant for a Camp Olympia Scholarship.*

Phone

This field is for validation purposes and should be left unchanged.