Online CAMP Application

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Email *

Personal Information

Full Name: *

Date of Birth *

YYYY

Mailing Address *

Street, City, State, Zip Code

Cellphone Number *

Preferred Contact Method *

Phone

Mail

I am a *

DACA not eligible

U.S. Citizen

Permanent Resident

Gender *

Female

Male

Prefer not to say

What is your T-shirt Size? *

Emergency Contact REQUIRED: *

Name, Phone Number, Relationship, Address(street, city, state, zip code)

How did you learn about CAMP? *

School

Counselor

Friend

Parent

Teacher

Former CAMP student

CAMP Representative

Other:

Required

Sibling Information *

Name, DOB, School District, Grade Level

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