SummerBASH Scholarship Form
Please complete this form to apply for a Scholarship to attend a SummerBASH Event. Any information will be kept confidential. 
Go ahead and register for the event to secure your spot.  You will be contacted as soon as possible about the scholarship.
Sign in to Google to save your progress. Learn more
Participant's Name *
Participant's Contact Information *
Is the participant under 17 years old?
If under 17 years of age, Parent/Guardian's Name
What is the Camp, Event or Workshop that you would like to attend? *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Louisburg Library.

Does this form look suspicious? Report

Google Forms