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CCCA Regional Camper Scholarship Request
Let's get you to camp! Email campregistrar@cccadisciples.org if you have any questions.
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* Indicates required question
Requester's Name
*
Your answer
Requester's Email Address
*
Your answer
Attendee's Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
If under 19, attendee's grade this fall:
Your answer
Is the attendee affiliated with a CCCA Congregation? If yes, list below.
Your answer
What event(s) does this attendee wish to attend?
*
Men's Retreat
Spring Adult Retreat
Women's Retreat
Discovery Camp
Pioneer Camp
Family Camp 1
Junior Camp (JYF)
Chi Rho Camp
Created 2B Me
Christian Youth fellowship (CYF)
Young Adult Conference
Family Camp 2
Fall Adult Retreat
Required
Check our prices here.
What is the total fee for this desired event?
*
Your answer
Amount that I can afford to pay:
*
Your answer
Amount that my local congregation or another party can pay (if available):
*
Your answer
Remaining amount needed from CCCA Camper Scholarship Fund:
*
Your answer
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