Antiochian Village Camp Financial Assistance Form 2024
All forms are due by February 28th and financial assistance will be disbursed based according to need. Notification will be sent sometime in April.
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Antiochian Village Camper Financial Assistance Application 2024
Please ensure your camper is registered or on a waitlist, as financial assistance is only awarded to campers who are registered.  Is your child/camper currently registered for a session of camp? *
Camper First Name(s) - Please include names of each child *
Last Name *
Parent/Guardian Full Name *
City *
State *
Home Parish Name (If not a parish of the Antiochian Orthodox Archdiocese, please indicate which jurisdiction or write "non-Orthodox") *
Home Parish City & State *
Name of person filling out this form *
Email address of person filling out this form *
Phone # of person filling out this form (xxx) xxx-xxx *
# of Children in Family attending Camp *
Annual Household Income *
The tuition amount for a two-week session is $1,100.00 per camper.  How much of this amount is the family able to pay?  If more than one camper, please list the TOTAL amount the family is able to pay. *
Will your church be contributing any amount towards your camper(s) tuition? *
If previous answer is 'yes', please list amount if known.
Please list the total amount of financial assistance you are requesting from Antiochian Village. If more than one child, please list the total amount being requested with breakdown for each camper (i.e., $400.00 total, $200 each for John & Jane Doe). *
Please list the reasons/circumstances for requesting financial assistance.  Please be as specific as possible, as that helps us determine where to best distribute our limited funds. *
A copy of your responses will be emailed to the address you provided.
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