2019 Summer Camp Financial Assistance Application
The Mount St. Helens Institute believes that all youth should be able to benefit from learning at Mount St. Helens regardless of their ability to pay. Due to the generous support of donors and sponsors, financial assistance may be available to families that meet our requirements.

All information reported on the financial assistance application is confidential.

The application only needs to be completed once per family/household.

Applications will be considered as they are received.

The Mount St. Helens Institute may require supporting documentation on income or circumstances.

Assistance will be provided based on eligibility and available funds.

Mount St. Helens Institute will notify you of your financial assistance status which may include: a full or partial award, registration code, wait-list for financial aid or not eligible for assistance.

A registration fee of $5.95 will be required to fully register for the camp.

Your First Name *
Your answer
Your Last Name *
Your answer
Mailing Address *
Your answer
Mailing Address City *
Your answer
Mailing Address State *
Your answer
Email Address *
Your answer
Phone Number
Your answer
I am applying for financial assistance for... *
Required
I am completing this application on behalf of... *
Number of people living in the house: *
Your answer
Number of people with income (all income is considered income) *
Your answer
Number of children (under 18) living in the house *
Your answer
Children lives with: *
Total household income *
Income includes salaries, wages, alimony, child support, social security, disability, public assistance, etc. Please be prepared to provide MSHI with supporting tax documentation if requested.
Your answer
Does your child/children receive free or reduced meals? *
Are there other extenuating circumstances that affect your family’s ability to contribute to camp? Please describe. *
Please be prepared to provide MSHI with supporting documentation if requested.
Your answer
ELECTRONIC SIGNATURE *
By entering my name below, I attest that all of the above information in complete and honest to the extent of my knowledge including any relevant background information that has not directly been asked about. I recognize that false claims of need may result in cancelled registration.
Your answer
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