ExplorationWorks Scholarship Form
The ExplorationWorks scholarship fund ensures that all families have the chance to experience ExplorationWorks' interactive and fun-filled science education programming. There are a limited number of scholarships available. Please make your request and wait for a response from the scholarship committee before signing your student up for camp. No refunds will be given for the cost of a camp if you have already paid for the camp and receive a scholarship. Please submit a form for each child.
Student First Name
Student Last Name
School that your student attends
Four Georgians Elementary
Jim Darcy Elementary
Prickly Pear Elementary
Helena Christian School
Montana City School
C R Anderson Middle School
Helena Middle School
East Valley Middle School
Helena High School
Capital High School
Other (not listed here)
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Phone Number (Please include area code)
Preferred method of contact
Camp and dates for which funds are requested: (Please choose your top three camp choices, as some camps fill quickly and may already be full)
Please check the scholarship amount you are requesting (Note: Percentages are of the member price)
Do you qualify for any of the following assistance programs? Please check all that apply.
Free and Reduced School Lunch
LIEAP (Low Income Energy Assistance Program)
SNAP (Supplemental Nutrition Assistance Program)
Housing Choice Vouchers
WIC (Women, Infants and Children Food and Nutrition service)
Have used the Helena Food Share in the last year
Have recieved services from Good Samaritans Ministries in the last year
None of these
If you do not qualify for any of the above assistance programs, please describe your financial need:
Please describe how you hope your student will be impacted by participating in an ExplorationWorks program:
Would you be willing to be contacted to provide a testimonial about the impact of our scholarship fund?
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