Summer Science Adventures 2017 Scholarship Request
May 15th, 2017 UPDATE: We have awarded all of the current Summer Camp Funding. If you complete this application, your child will be added to the Scholarship Wait List. We will contact you if funds become available and give you a limited amount of time to complete the application & registration process.

Please use this form to apply for financial assistance for Science Factory Summer Science Adventures.

We award scholarship as funding allows. It is awarded based on the date of application and the information that you provide. Please submit the scholarship request form and wait for a response BEFORE registering for any camps. We are generally not able to return funds if you pay for a camp and then receive a scholarship.

If found eligible, one partial or full scholarship will be awarded per camper, per camp year. You will need to provide the name and date of the camp for which you are interested in receiving a scholarship. Camp schedules and descriptions can be found here: www.sciencefactory.org/summer.

Siblings are eligible for individual scholarships, but a separate scholarship request must be submitted for each camper.

You will be notified within two weeks of submitting the application. Please watch for notification via email or phone. If you are approved for 100% scholarship, you will be required to pay a $10 cash deposit to hold your child's place in the camp. This deposit will be refunded to you if your child participates the camp as arranged. If we contact you but do not hear back in a timely manner, we may have to place your application back into the pending queue.

If you have questions regarding the application or process, please call 541-682-7895 or email info@sciencefactory.org.

Child First Name
Your answer
Child Last Name
Your answer
Child Birthdate
MM
/
DD
/
YYYY
Child Grade in Fall of 2017
Your answer
Guardian First and Last Name
Your answer
Guardian Phone Number
Your answer
Guardian Email Address
Your answer
Guardian preferred form of contact
City and State of Residence
Your answer
Are you a current member of Science Factory?
If you are a member, please provide the member number or primary first and last name.
Your answer
Camp Name & Date
If you do not include a specific camp name and date, your scholarship application will be considered incomplete. Answers of "all summer" or "any Investigator Camp" will not be accepted.
Please provide the dates of the camp (Example: June 26-30)
Your answer
Please provide the name of the camp for which you would like scholarship.
Your answer
Please provide information about your financial needs.
We ask that you provide information based on your current ability to enroll in, attend and pay for the camps that you are are interested in. You will be required to submit proof of need.
Monthly Gross Household Income from all sources
Your answer
Number of family members this income supports
Your answer
How much of the camp cost do you feel that your family can provide?
Is there any other information we would find helpful in determining your level of need?
Your answer
Documentation of Need for Assistance
Please submit documentation related to your household size and income. There are several ways to do this:

1) Follow the link on the next page to upload your document(s) directly to us (this method is preferred).

2) Send your document(s) as attachments in an email to info@sciencefactory.org. Be sure to include your child's name so that we can match your document to your application.

3) Mail it or bring your document(s) to: Science Factory, 2300 Leo Harris Pkwy, Eugene, OR 97401.

Our preferred documentation is a copy of your child's approval for Free or Reduced School lunch. This proof should be provided to you through your child's school. The next best documentation is a copy of your most recent SNAP approval letter, which contains the family size and income.

Other forms of documentation that may be accepted are: 2016 Income Tax Summary Page (please remove SS #), Self-Employment Records, most recent WIC ID card (not the benefits card), or OHP card issued within the last 12 months.

Your application will not be processed until we receive your documentation.

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