Camp Glen Brook Campership Assistance Application 2020
Campership is available due to the generosity of our donors. Campership is specifically for campers who would not otherwise be able to afford a summer experience at Camp Glen Brook.

Step 1: Fill out the following form completely and submit a copy of your most recently completed IRS 1040 or 1040A to or Camp Glen Brook 35 Glen Brook Road Marlborough NH 03455

Step 2: Apply for your child(ren) online at

Step 3: Your application will be considered on a rolling basis beginning in mid February until our campership funds are depleted.

If we can offer adequate assistance, we will agree upon a deposit and payment schedule.
If we cannot offer adequate assistance, you will be notified and your registration will be cancelled.
Email address *
Camper First Name *
(If applying for multiple campers write it as: "Name 1, Name 2, Name 3")
Camper Last Name *
Camp Session Requested *
Are you flexible about which session your child(ren) attend? *
Current grade of child/children *
How big is your household including yourself and all of your dependents? *
Parent/Guardian 1 Occupation *
Parent/Guardian 1 Annual Gross Salary *
Parent/Guardian 2 Occupation *
Parent/Guardian 2 Annual Gross Salary *
Please describe any other sources of income, including amounts.
This Year's IRS Adjusted Gross Income *
You must also send in a copy of your 1040 form, both forms if filing separately. These go to
Do you have any assets beside your primary residence, car, and/or retirement funds? *
If so, please describe type and amount
How much, if any, child support do you receive? *
How much outside support (from family or other sources) will you receive toward a camp experience for your child(ren)? *
Do you own or rent your home? *
Monthly rent or mortgage and/or tax payment *
Are there any special circumstances you wish the committee to consider? *
Total Campership Assistance needed AFTER all applicable discounts (Early Bird, Buddy, Sibling) *
By typing my name in the below box, I assert that the information on this form is true and accurate to the best of my knowledge. I also acknowledge that camperships come from money raised specifically for campers who could not otherwise afford to attend Camp Glen Brook, and assert that I could not find a way for my camper to attend without the requested campership. *
Never submit passwords through Google Forms.
This form was created inside of Camp Glen Brook. Report Abuse