Camp Bed-Stuy 2016 - Financial Assistance
We ask for a deposit in order to hold your child’s spot for camp. We do not offer full financial assistance, but do our best to assist our families based on income and financial need.

Any deposit that is made goes towards your camp fees.

First Name
Camper
Your answer
Last Name
Camper
Your answer
Age
Your answer
Grade
Your answer
Current School
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
First Name
Parent (1)
Your answer
Last Name
Parent (1)
Your answer
Cell Phone
Your answer
Home Phone
Your answer
Email
Your answer
Home Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
First Name
Parent (2)
Your answer
Last Name
Parent (2)
Your answer
Cell Phone
Your answer
Home Phone
Your answer
Email
Your answer
Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Combined household monthly earnings (before taxes):
Your answer
Additional household income (this includes Social Security benefits, unemployment, federal/state aid, alimony, Veteran’s benefits, etc.):
Your answer
Total number of people living in the household supported by above income:
Your answer
Number of children in household
Your answer
Sessions
What are you able to contribute?
(based on total number of sessions above checked)
Your answer
How much assistance you will need?
(based on the total number of sessions checked minus your contribution)
Your answer
Are you at 1199 or Local 100 member?
School
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