Mecklenburg County 4-H Residential Camp Scholarship Application
The Mecklenburg County 4 -H Program is an Equal Opportunity Program. All applicants for this scholarship must reside in Mecklenburg County. Applications must be received on or before March 18, 2022 by 5pm. Scholarships are awarded first-come/first serve, pending funding availability (Funding is not guaranteed). 4-H Online Profiles and Camp Forms with a commitment to attend camp must also be submitted to be considered for a scholarship.
Scholarships are awarded based on need. Partial and full scholarships are available (See listing below for details).

Tier 1 - $100
Tier 2 - $200
Tier 3 - $300
Tier 4 - $400 (full cost with $50 deposit to be paid by camper)

All information will be held in confidence and will be used only in the determination of scholarship recipients. Limit one scholarship per household. Parents can apply for one scholarship to be divided among more than one child. Scholarships will be disbursed by a scholarship committee board based on camping spaces available and funds available. If you have any questions please contact Catherine Daniels- or at 704-336-2082.
Sign in to Google to save your progress. Learn more
Email *
Child's Name *
Date of Birth *
Address *
Phone Number *
4-H Group (If applicable; If you are a member of a 4-H group in Mecklenburg County)
Parent/Guardian Name *
What is the gross yearly income of all persons in your household? *
Other income for the past 12 months (please list- example: AFDC) (Say N/A if not applicable) *
How many family members live at home? *
Has your child attended 4-H camp before? *
Does your prospective camper belong to any of the following groups or categories considered to be vulnerable youth populations? Check all that apply. *
Please choose one funding tier for your prospective camper from the list below. Funding is not guaranteed. *
Please describe in 300 words or less why your prospective camper is a great candidate to receive scholarship funding to attend camp this summer. Please provide justification for the funding tier you are applying for. *
Will your child be able to attend camp without financial assistance? *
Have you submitted the 2022 Camp Forms and the 4-H Online Profile ( *
4-H Online
If you have not completed the above requirement, please complete the profile and submit camp forms in order to be considered for scholarship funds. Scholarship applications will not be reviewed until the required camp documents and profile have been completed. Follow this link for a tutorial video to complete the 4-H Online Profile
By typing your first & last name in the box below you agree that this information is true to the best of your knowledge. *
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This form was created inside of North Carolina State University. Report Abuse