CCV Campership Application Form

Complete the Form and click Submit

 

Applicant Information



First  Middle  Last 
Name of Parent or Guardian 
Address 1 
Address 2 
City   State  Zip 
Main Phone 
Alternate Phone 
Email Address 

Event Information

Date(s) of Event:  to 
Name of Event 
Event Location
 
Cost of Event $  (Sr. High Alive Camp is $380, Jr./Sr. High at Spencer Lake is $170)
Is applicant a member of CCV?  
Does applicant attend Youth Gathering? 
If not, where does the applicant attend? 
How did applicant contribute to Fund Raising events?

Amount Requested
Date Scholarship is needed by 

Amount Requested
Non-specific requests such as "Whatever is available" will not be processed.  Please quantify the exact financial need.


Other amount requested: $ 

The Student Ministries department will do our best to accommodate the need of the applicant.  Information on this applicatoin will be kept confidential.


Please read the following

I acknowledge that the information entered above is true to the best of my knowledge.  I am either the student requesting funds, or a parent/legal guardian of the student.  I understand that this is a confidential request, and that I may not receive all funds requested.  Scholarship funds will be provided based on need, request, timeliness of request, and availability of resources.  This does not represent a guarantee of funds.  I understand that any scholarship funds provided are non-transferable.  If funds are provided, but not used for the specified event, they must be returned.

 I have read the above statement and agree that it is true.