Care & Connect Scholarship Application

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Westview's scholarship program to attend summer camp

Camper's Name *

Gender *

Male

Female

Date of Birth

Name of Parent/Guardian *

Address

Primary Phone Number

Email Address *

Church Camper Attends

Camper: Tell us why you want to come to camp. *

Please complete the reference information below. You must submit a reference letter from a pastor, youth or children's leader, principal, teacher or social worker. This letter can be emailed to info@westviewonthejames.org or mail to 1231 West View Road, Goochland, VA 23063

Reference Name *

Reference Position (pastor, youth or children's leader, school principal or social worker) *

Reference Phone Number *

Reference Email Address *

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