Camp Santa Cruz Scholarship Request

Student

Child's Information

First Name

Last Name

Gender

Grade

Birthday

/ /

Parent/Guardian's Information

Parent/Guardian Name

Parent/Guardian Address

Scholarship Information

Do you currently attend weekly NorthPointe church services?

No Yes

Was your child invited by someone who regularly attends NorthPointe church services?

No Yes

How did you find out about Camp?

Scholarships are given based on need. The information here is important in making the best decision for everyone applying for scholarships. Please take care in providing the most accurate information.

What is your household income?

Less than $35K $35K to $45K $45K to $55K $55K to $65K $65K to $75K $75K to $85K More than $85K

How many adults (18 years and older) live in your household?

How many children (younger than 18 years) live in your household?

What is the scholarship amount you are requesting?

Please explain why you are needing a scholarship for your child to attend Camp?

Once we recieve and/or approve your scholarship application, we will contact you to discuss your application and the scholarship funds being provided by NorthPointe Student Ministries as well as any payment arrangements for your portion of the fees

By signing this form, and upon approval of this application, I understand and agree to:

Register my child for Winter Camp within (1) week of approval

Make the agreed upon deposit at the time of registration

Make additional payments as agreed uopn for my portion of the fees

Give a minimum of (4) weeks notice if my child is unable to attend

Agreement

Agreement is required.

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