Parent Application - Diabetes Training Camp Teen Boot Camp Scholarship

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Scholarships to Diabetes Training Camp (DTC) are intended to cover a portion or all of the registration fee for camp based on applicant need. Scholarships do not include travel expenses or other incidentals. DTC scholarships will not be awarded to the same camper in consecutive years. The application process is a competitive process as DTC has limited funding for scholarships. Awards are based on the information you provide to us so please be as detailed as possible.

NOTE: There is a separate teen portion of this application which you can access HERE:

https://docs.google.com/forms/d/e/1FAIpQLSdw98jg17p8eLZqtlvRaLjOWZmwQ-wR0K17umqWjMtzBBQ89w/viewform. In order to be considered, both portions must be completed.

Email *

Parent's Last Name *

Parent's First Name *

Parent's Preferred Phone Number *

Teen's Last Name *

Teen's First Name *

Teen's Date of Birth *

YYYY

Grade teen will be entering in the fall of this year *

City and State of Residence *

What type of diabetes does your teen live with? *

Type 1

Type 2

Other:

Approximate date of your teen's diagnosis *

Do any other family members live with diabetes? (including parents, grandparents, siblings, aunts, uncles, cousins, etc.)
*

Yes

Please provide the relationship to your child of the family member living with diabetes. (include all that apply)

Are you or your teen a DTC alumni? *

Yes

If you or your teen is a DTC alumni, please provide the years and locations of the DTC camps attended.

Has your family received a scholarship to DTC in the past? *

Yes

If your family has received a past scholarship please list the year(s) the scholarship(s) were used.

Describe your experience of living with diabetes in your family in three words. *

How do you think you and your teen will benefit from attending DTC's Teen Boot Camp? *

What do you hope to leave DTC's Teen Boot Camp with? *

How does your teen spend their free time? (there is no right or wrong answer) *

What is your teen passionate about? *

What physical activities does your teen currently participate in? *

Does your teen have any big goals in the coming years- academic, social, clubs, sports, etc? *

What three goals do you have related to your teen's diabetes wellness? *

What resources and/or people do you have to support you and your teen in terms of living with diabetes? *

DTC has a limited scholarship pool. Historically, the scholarship selection committee has had to make difficult decisions in terms of granting partial or full scholarships. Based on the cost of camp ($2750), how much are you able to contribute towards your family's DTC camp experience?
*

Why do you feel your family should receive financial aid to attend DTC's Teen Boot Camp. Please be as specific as possible and include any unusual circumstances that the scholarship committee should be aware of (e.g., low income, employment status, life changes, medical bills, family obligations, etc.):

Are you and/or your co-parent employed? If yes, what do you do for work? *

What is your total annual household income? *

How many dependents are in your family? *

Is there anything else you would like the scholarship committee to know while considering your application?

Thank you for applying for financial aid for Diabetes Training Camp's Teen Boot Camp! Once our committee has made its selections you will be contacted.

A copy of your responses will be emailed to the address you provided.

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