JCAS Scholarship Application Form: Summer 2020
A limited number of need-based scholarships are available for the Junior Center of Art and Science's Summer Camp programs. Please be sure to read the entire application before filling it out. Scholarships are awarded to campers based on financial need. All information is confidential.
Only partial scholarships are available. Parents must be prepared to pay the remaining tuition balance or make arrangements for payment plan by the due date if the scholarship is accepted. Awards are dependent on application pool and available funds. If the tuition balance is not received by the due date, the scholarship and space in the class will be given to the next camper on the waiting list. We appreciate your understanding.

DEADLINE for SUBMITTING APPLICATIONS: March 1

NOTIFICATION of AWARDS: March 15
Email address *
Date 2/2/2020 *
MM
/
DD
/
YYYY
Camper's Name: Marcelo De Sousa *
Your answer
Parent's Name: Jaclyn Burleigh *
Your answer
Address: 229 MacArthur Blvd Apt. 1G *
Your answer
City: Oakland *
Your answer
Zipcode: 94610 *
Your answer
Phone (day): 415-713-9229 *
Your answer
Email Address: jaclyn.burleigh@gmail.com *
Your answer
School Camper Attends : Walden Center & School *
Your answer
City of School: Berkeley *
Your answer
Camper's Birth Date: 03/17/2012 *
MM
/
DD
/
YYYY
Number of people in household: 3 *
Your answer
Number of household members employed: 2 *
Your answer
Name(s) of Employers : (Jaclyn) ReActive Movement (Fausto) Self Employed *
Your answer
If no members employed, state means of support: N/A *
Your answer
Annual Household Income *
Required
Course Requested (one course per camper): First Choice : Carpentry 2 *
Your answer
Course Requested (one course per camper): Second Choice: Stop Motion Animation *
Your answer
By typing my name I certify all the above information is true and correct to the best of my knowledge. Jaclyn Burleigh *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of The Junior Center of Art and Science. Report Abuse