Camp HEAL Incentive Application
Deadline to complete: July 1, 2019. Questions? Please contact Ali@theprojectheal.org
Incentive Application
1. This form is for chapters/ambassadors who have raised a minimum of $1,000 Net (profit-expenses) since January 1, 2019.
2. For every $1,000 NET raised by July 1, 2019, Chapters/Ambassadors qualify for one (1) campership. Example if a chapter or ambassador raises $1,700 net, they receive one campership. If a chapter or ambassador raises $2,100, they earn 2 camperships.
3. Camperships do NOT include transportation. Chapters/Ambassadors may apply for financial assistance for travel until March 15, 2019 (separate form that can be accessed here: https://goo.gl/forms/FsmG33SFt3a2nC2T2 ).
4. Camperships can be swapped out for individuals as long as Project HEAL has not assisted with transportation.
5. You may fill out this form multiple times as you continue to raise funds and earn more campership incentives.
6. If your chapter has more incentives than volunteers who want to attend, you may donate the camperships to another chapter.

Last Name *
Your answer
First Name *
Your answer
Age *
Your answer
Email Address *
Your answer
Full Mailing Address (Don't forget City, State, and Zip) *
Your answer
Project HEAL Chapter or Ambassador Site *
Your answer
Volunteer Role of Person Submitting the Form *
Your answer
How much as your chapter/ambassador site raised in net funds since January, 2019?
Your answer
How many camperships are you requesting? *
Your answer
If you have more available campership incentives than you have volunteers to attend, are you willing to donate one of your camperships to another chapter?
Who will be receiving the campership incentives? (Name, Chapter Role, and email address)
Your answer
Why do you want to come to Camp HEAL? *
Your answer
Please list any additional chapter members who will be coming to Camp HEAL not included in the above.
Your answer
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