Camp Autrey Mill Financial Assistance Form
Autrey Mill Nature Preserve Association has established a camp Financial Assistance fund sponsored by the Country Club of the South Charity Guild for families in need who would like to send a child to a week of Camp Autrey Mill in the summer of 2024.

* Financial Assistance is awarded on an individual basis determined by need

* Financial Assistance may be requested for one camp session only

* Documentation of income may be requested upon review of this application

* Financial Assistance will be reviewed on: February 28th, March 31st, and April 30th

* The Financial Assistance application must be completed in full and returned before each date listed above.
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Parent or Guardian Name (First, Last) *
Contact Email *
Contact Phone *
Child 1: Name (First, Last) *
Child 2: Name (First, Last)
Child 3: Name (First, Last)
Child 1: Birthdate *
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Child 2: Birthdate
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Child 3: Birthdate
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Check 2-3 options for preferred week & theme of camp *
Required
Why do you need financial Assistance for your child to attend camp? Give Specific details to support your need. *
# of Family Members in Household *
# of Children in household under 18 *
# of Adults in Household *
Family Yearly Income *
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