GWVAS Nature Camp Scholarship 2008 Application

** Recipients will be responsible for their own transportation to and from camp, and for paying the remainder of the camp fee not covered by the scholarship.

Applicant's Name

Address

Phone E-mail

Date of Birth Male Female

Parents' or Guardians' Names

Address (if different from above)

Phone E-mail

Camp Location (circle one)

Bear Creek Camp

Endless Mountains Nature Center

Nescopeck State Park

Penn State CLS

Session Number

PLEASE ENCLOSE THE FOLLOWING WITH APPLICATION:

* A brief explanation from child as to why he/she would like to attend.

* A note from a parent/guardian stating that he/she supports the applicant's effort to attend the camp.

* For Penn State CLS Only: A recommendation from a teacher, guidance counselor or youth leader from the community.

APPLICATION DEADLINE: May 23, 2008

SEND TO:

Diane Madl, Scholarship Program

1137 Honey Hole Road, Drums, PA 18222

Fax: 570-403-2008

For more information about the scholarship program, contact Diane Madl at 403-2006. Scholarship recipients will be notified by June 6, 2008.