Camp CILCA Outdoor Ministries Bernice Piper Scholarship Application

The purpose of this application is to provide the opportunity for children to experience Christian camping. We ask that funds also be sought from second sources such as the camper’s home congregation. We also urge that parents/guardians provide a portion of the cost, if possible, so that our funds will be available for other children as well. Scholarships are not available for specialty camps. You will be notified of your scholarship amount AFTER May 15th.

The total cost for a camp session is:

Full week - $220 Half week - $120 Parent-child/Kinderkamp - $37.50 per person

The cost of this camp will be assumed by: Parent/Guardian will finance $________

Congregation will finance $________

Other sponsor will finance $________

Financial assistance requested for each camper is $ _______. A brief explanation why scholarship award is requested:

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APPLICATIONS SHOULD BE SENT TO CAMP NO LATER THAN MAY 15TH. ALL FORMS SHOULD BE MAILED TO:

Rich Harkins – Director - Camp CILCA Outdoor Ministries

4124 Camp CILCA Rd. - Cantrall, IL 62625

Camper’s Name: ________________________________________________________________

Parent or Guardian: _____________________________________________________________

Camper’s Home Congregation: ____________________________________________________

Address: _______________________________________________________________________

Telephone: ____________________________ Camp week desired: _______________________

APPLICANT ACCEPTANCE: I hereby give my permission, as parent or guardian, for the minor child named above to attend Camp CILCA by way of the Bernice Piper Scholarship Fund. I also hereby give Camp CILCA permission to obtain needed information to assist in the determination of this application.

Parent/guardian signature _________________________________________   Date _______________________