TIC Campership Application

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Thank you for requesting a campership application for our summer camp. The TIC Summer
Campership Program is supported by generous friends of TIC Summer Camp as
well as funds allocated by TIC Summer Camp itself. It is our hope that each family
would pay what they can to help us extend financial assistance to as many families as
possible. The application below helps us determine how to distribute the funds and is
considered completely private.

Scholarships are reviewed and awarded on a rolling basis until the funds are depleted. We
recommend submitting your application as soon as possible as funds are usually distributed by
April 15.

Today's Date *

YYYY

Name of Camper *

Camper's Date of Birth *

YYYY

Camper's Grade Next September *

School Camper Attends *

Name of Parent/Guardian *

Home Address *

Phone # *

Email Address *

Which site would you prefer to attend? *

TIC‐DC: Georgetown Day School, 4200 Davenport St. NW, Washington DC 20016

TIC‐MD: Sidwell Lower School, 5100 Edgemoor Ln. Bethesda, MD 20814

VA-McLean: St. John Academy, 6422 Linway Terr. McLean, VA 22101

VA-Fairfax: The New School of Northern Virginia, 9431 Silver King Ct. Fairfax, VA 22031

For camper: Please explain why you would like to attend TIC Summer Camp, describing your interest in technology instruction and how you think the camp program might benefit you *

Does your child receive any financial aid at school? *

Yes

Current gross family income: *

Number of dependents *

Number of dependent children attending TIC Summer Camp *

Has the camper attended TIC Summer Camp before? *

Yes

Has this camper received TIC Summer Camp scholarships in the past? *

Yes

How much can you afford to pay (per child) for the two week session of camp? *

Would a payment plan be of assistance? *

Yes

Signature: *

By typing your name you are stating that all provided information is accurate.

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