Camper Scholarship Application

Camper's Full Name*

Age*

Sex*

Female
Male

School (2019-2020 school year)

School Grade (2019-2020 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 $3,750 and 3-week term is $4,750.

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: At least one reference form must be completed by a NON-FAMILY member.

Reference will be submitted from:*

Below is a list of the Camp Olympia 2020 Summer Camp Term Dates. Please note that availability for scholarships varies within each term. *SPARK Week Terms are for 6-9 year old campers only. All other camp terms are for 7 – 16 year old campers.

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.*

Name

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