4-H Camp Scholarship Application
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Collapse ▲4-H Camp Scholarship Application
Please give as much of the following information as possible and return to:
Donna Mull, 4-H Agent
Cooperative Extension Service
PO Box 389
Newton, NC 28658.
E-mail to: donna_mull@ncsu.edu
Call 828- 465-8240 or e-mail if you have any questions. Scholarships provided by Hickory Kiwanis Club and Nolley 4-H Endowment.
Child’s Name__________________________________________Age______M_____F_____
Address____________________________________________________________
Phone_____________ E-mail_______________________________________________
Parents or Guardians_________________________________________________________
Mother’s place of Employment_________________________________________________
Position_______________________________________________________________
Father’s place of Employment_________________________________________________
Position________________________________________________________________
Number of Family Members_______ Has the child attended camp before? _____yes _____no Where and When?
Is the child/family aware they have been nominated for a camp scholarship?
Yes No
Amount family could pay toward Camp Cost: _____________
(Scholarship winners are asked to pay some portion toward the camp cost.)
Describe what you know of family’s financial situation: (Attach separate page if necessary)
If this child receives a camp scholarship, who would be willing to work with the family and the 4-H program to insure that the proper paperwork is completed and that the child has transportation to and from the camp bus?
Name________________________________________________Phone____________
This information is true to be best of my knowledge:
________________________________________________Title___________________
Agency/School___________________________________________________
Address:____________________________________________Phone_____________
*All information provided will be held in confidence and will be used only in determination of scholarship recipients.
Attach the following:
- LETTERS OF RECOMMENDATION FROM AN ADULT WHO KNOWS THE CHILD STATING WHY THE CHILD SHOULD RECEIVE A SCHOLARSHIP.
- PARAGRAPH WRITTEN BY THE CHILD EXPLAINING WHY THEY WANT TO ATTEND CAMP AND WHY THEY ARE SEEKING A SCHOLARSHIP.