Scholarship Form for summer 2012
Please fill out this form and send the Marymount office a copy of your last tax return and most recent paystub(s). PLEASE SEND ALL PAPERWORK TOGETHER & NOT SEPERATELY. YOUR SCHOLARSHIP REQUEST WILL NOT BE PROCESSED IF WE DO NOT HAVE THE FOLLOWING:
-Completed camp application with $100.00 deposit (check will not be cashed until scholarship is accepted
- Completed scholarship application (this form)
- Copy of your latest tax return
- Copy of most recent paystub(s).
If scholarship is not accepted or application is denied the deposit is fully refundable. Once the scholarship is accepted all rules regarding deposit and tuition apply. Please remember that funds are limited and all scholarships will be given out on an as needed basis as well as first come first serve. Scholarships will start to be awarded in March 2012 . We will continue distributing scholarships until funds are depleted. If you have any questions or concerns please feel free to call the office at 615-799-0410.
Partial Scholarships are available on a first come first serve basis for qualified children who desire to attend Camp Marymount, Inc. Criteria include child’s need for a Camp experience, economic and social needs, and inability for parents to meet the financial costs of Camp for one or more children due to a lack of income. “Rules for acceptance and participation in the camp program are the same without regard to race, sex, age, color, religion or national origin.” A deposit check of $100.00 is required to reserve a spot at Camp Marymount. For Scholarship applicants only, this deposit check will not be cashed until the applicant is notified and has accepted his/her scholarship. Once accepted the check will be cashed and all non refundable rules apply.
The following information is required for our Scholarship Committee, and is strictly confidential.
By entering your name you have read and understand the above statements.
Please enter your camper's name:
Enter your camper's age:
Enter your camper's grade (the grade he/she will be entering during the summer 2012):
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Phone Number (best number to reach you)
Your Email Address
Name of camper's School
Name of Parent(s)/Guardians(s)
Are the parents:
Occupation(s) of parent(s)/ guardian(s)
ALL gross income per month including child support, government checks, and other income payments of any kind. (before deductions)
Number of persons in home. (Please list the names and ages of those under 18 years of age
Describe child’s home environment and what the circumstances are that have created a need for financial assistance:
Please outline personal issues the child or family have encountered or special obstacles they must overcome:
Describe positive qualities the child or family have demonstrated and why the child should be considered for a scholarship.
Any additional pertinent information or comments:
Please give name, position or title, agency and phone number of clergyman, welfare worker, school official or other professional who can verify this information:
Name of person completing this form
Relation to camper:
Please select the session the camper is applying for:
Please Choose One
girls two week-junior camp (rising first graders thru rising 8th graders) May 27- June 9
girls two week -senior camp(rising 9th grader thru rising 11th graders) May 27- June 9
girls three week - junior camp (rising first graders thru rising 8th graders) June 10- June 30
girls three week- senior camp (rising 9th grader thru rising 11th graders) June 10- June 30
boys three week- junior camp (rising 1st graders thru rising 7th graders) July 8- July 28
boys three week- senior camp (rising 8th graders thru rising 11th graders) July 8- July 28
If your child does not get into his or her preferred session (listed above), what is their second preferred session?
Have you received Scholarship $ from Camp Marymount previously?
If yes, what amount?
If yes, which year(s)?
We rarely give out “full” scholarships. What amount can the family contribute to the Camp Fee:
Is this child attending another camp this summer?
Please Note: All incomplete forms will be returned to applicant.Your scholarship application is not complete until all required forms are submitted to the office. Please submit the forms (tax returns, most recent paystub, and your deposit) within 2 weeks of submitting this form. It's your responsbility to ensure all required paperword is submitted. Scholarships will not be awarded without all requested information and without $100.00 deposit.
Scholarship funds are limited, and are based on a first come - first serve basis. Scholarship applicants must also complete the online camper registration at www.campmarymount.com
All scholarship paperwork should be mailed to :
Camp Marymount, Inc.
1318 Fairview Blvd
Fairview, TN 37062
If you have any questions, please call:
Dana Hummel , camp registrar
(615) 799-0410 or email firstname.lastname@example.org
By entering your name you agree to the above scholarship requirements and procedures:
Do Not Fill This Out