Pilgrim Pines 2019 Campership Application
Thank you for applying for Campership funds for your camper to attend our 2019 Summer Camp. This application can be completed ONLY by those requesting $250 or less in assistance AND are eligible under our income guidelines. If you are requesting additional funds, or are requesting assistance without meeting our eligibility guidelines, please contact us in order to complete and mail a paper application. WE MAY REQUEST VERIFICATION OF ELIGIBILITY AT ANY TIME. Please contact us with any questions.
Camper's Information
Camper's First Name *
Your answer
Camper's Last Name *
Your answer
Camper's Address *
Your answer
Camper's City, State and ZIP *
Your answer
Camper's Date of Birth *
MM
/
DD
/
YYYY
Grade entering Fall 2019 *
Age on July 1, 2019 *
Your answer
Week Requested for Camp *
Camper Age Group *
Race/Ethnic Group
Optional. Some of our donors request this information.
If your camper has a home church, please list the name and city here
Your answer
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