Campership Application Form - 2016
ADVERTISEMENT
1Hawk Mountain Council
Boy Scouts of America
2016 CAMPERSHIP APPLICATION
(DEADLINE – MAY 1, 2016)
FORMS WILL BE REVIEWED IN THE ORDER THEY ARE RECEIVED. DATE RECEVIED IN COUNCIL: ___________________________
DIRECTIONS:
1. Please PRINT all information. Parent and/or guardian must complete ALL information. Unit Leader must sign on Line 14.
2. Applications must be mailed to:
Hawk Mountain Council, BSA, 5027 Pottsville Pike, Reading, PA 19605
3. Completion of this form DOES NOT automatically guarantee a campership. Camperships are made, first on the basis of verified
need and second, on the basis of funds available.
4. Campership applicants must be currently registered in the Unit stated on this application and must be attending a Hawk Mountain
Council, BSA summer camp during the 2016 summer season.
5. The typical amount of campership funds granted is 25%-33% of the total camp fee, although a greater amount may be granted
under exceptional circumstances. A granted campership in the applicant’s name that is not used in the current year is not
transferable to the following year.
6. Approved applicants will be notified in writing.
PACK #: __________ TROOP #: __________ DISTRICT: ________________________ Date of Application: ______/______/______
1. APPLICANT’S NAME _________________________________________________________________ DOB _____/______/_____
2. PARENT’S/GUARDIAN’S NAMES_____________________________________________________________________________
3. ADDRESS: ________________________ CITY: _________________ ST: _____ ZIP: _______ PHONE: (_____) _____ - _______
4. DATES ATTENDING CAMP: From: ______/______/______
To: ______/______/______
5.
WEBELOS
CUB SCOUT DAY CAMP
CUB SCOUT RESIDENT CAMP
EXTENDED
BOY SCOUT RESIDENT CAMP
6A. Total Household Income (2015):
under $15K
$15K - $25K
$25K - $50K
$50K - $75K
over $75K
6B. Parental Status:
Married
Single Parent
Non-Parent Guardian
Ward of Court
Other
____________
6C. Number of siblings attending Camp as:
CUB SCOUT(S) _______ WEBELOS SCOUT(S) _______BOY SCOUT(S) ______
7.
Reason for the campership request: If more space is needed continue on the back of this form or attach a separate sheet.
(signed by Parent/guardian)_________________________________________________________________________________
___________________________________________________________________________________________________________
____________________________________________________________ Signature: ______________________________________
TOTAL CAMP FEE ……………………….……………
8.
$ ____________________
Scout’s share of camp fee ………………….…………
9.
$ ____________________
(Popcorn sales/fundraising)
10. Family’s share of camp fee ……………………………
$ ____________________
(Required)
11. Share of camp fee from the unit ………………………
$ ____________________
(Required)
12. Share of camp fee from Chartered Partner/other sources $ ____________________
13. Amount requested from the Campership Fund ………
$ ____________________
14. Certification: I hereby certify that, to the best of my knowledge, the reason given for this campership request is accurate. Two
signatures are required – Unit Leader/Committee Chairman/District Representative.
Signature:
__________________________________
Signature:
__________________________________
OFFICIAL USE ONLY
APPLICANT APPROVED:
For:
$_________________________________
DATE: ________/________/________
HOLD FOR ADDITIONAL INFORMATION: __________________________________
DATE: ________/________/________
APPLICATION NOT APPROVED:
__________________________________
DATE: ________/________/________
Revised 1/27/2016
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business