Summer Farm Care/Camp Scholarship Application

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Our goal is to make our programs available to everyone. We offer full and partial financial assistance based on need.

First Name of Applicant: *

Last Name of Applicant: *

Phone Number: *

Email Address: *

First Name of Camper(s): *

Last Name of Camper(s): *

Child lives with: *

Single Parent/Guardian

Two Parents/Guardians

Foster Parent

Group Home

Other

Total number of children/dependents in family:

Combined gross family income per year:

Child support or other income per year:

Reason for Requesting Financial Assistance: *

How much can your family put towards camp fees? *

Is there any other information about yourself or your child that you would like to include in this application? *

Proof of Income (For Financial Assistance Application)

You must submit proof of income within 1 week of today to receive assistance. Please email or mail a copy of EITHER your family's most recent federal tax return (2017 ok) OR combined family W-2s, to: Farm Discovery Camp, PO Box 3490, Freedom, CA 95019

Please check the following and sign: *

I have read and completed all sections of this application and the information provided is correct.

Required

I am including my $50 deposit, to be returned if assistance is not granted or if full assistance is granted. You may submit your deposit with cash or checks payable to Farm Discovery / P.O. Box 3490 / Freedom, CA / 95019-3490. *

I will send a $50 payment to Farm Discovery.

I am requesting a full scholarship.

Required

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