2019 Summer Camp Bursary Application
Applications must be fully completed and received by 5pm June 7, 2019 to be considered.

Letters may accompany this application. EYES will only offer bursaries for applications for one week of camp as we have limited funds.

Please note that if you are applying for multiple youth, you must complete *different* applications for *each* youth you are applying for.

Email address *
Applicant (Child) Information
All Information will remain confidential
Child Name: First, Last *
Your answer
Reported combined net income from 2018 tax return for your family (required) *
Your answer
How many people are in your family? *
Your answer
Registration Funding Request *
Food Funding Request *
Please note that lunch is not available for youth attending satellite camps.
Why do you need a bursary for EYES? *
Please remember that selection is based solely on need.
Your answer
Is there anything else that you would like to tell us?
Your answer
Applicant (Parent/Guardian) Name (First, Last) *
Your answer
Date *
MM
/
DD
/
YYYY
What week(s) are you available to attend camp! *
Please select all that apply.
Required
What camp(s) are you wanting to attend? *
Please select all that apply. For more information, please visit: http://eyes.uregina.ca/camps/
Required
If you are applying to attend a satellite location, please indicate what location! *
For more information, please visit: http://eyes.uregina.ca/satellite-camps/
I understand that I will not be contacted regarding the status of my application until AFTER June 7th, 2019. *
I understand that my application does not guarantee my child a spot. Funding is distributed based solely on need. *
I understand that I will be contacted via the email given above, and that it is correct. *
Declaration: I hereby declare that all information given above is true and complete in every respect, that I have answered all questions on this form and that the bursary is essential to my child coming to camp. Furthermore, I agree that EYES has first claim to monies awarded, and that if my circumstances change from those reported on this application, the bursary may be rescinded. *
A copy of your responses will be emailed to the address you provided.
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