Mary Elizabeth Williams Summer Camp SCHOLARSHIP APPLICATION
The Mary Elizabeth Williams Summer Camp Scholarship, awarded each year by Junior Auxiliary of Tupelo, would help girls pay for summer camp to Camp Tik-A-Witha (Van Vleet, MS) or Kamp Kiwani (Middleton, TN). To find out ore about these camps please visit www.girlscoutshs.org/camp.

Please complete the entire application. Please NOTE that for you to be considered for this scholarship you would need to pay the $50 deposit.  All applications are confidential. Applicants must be current residents of LEE COUNTY. Scholarships are based on financial need without regard to race, religion, disability, or national origin.

APPLICATION DEADLINE IS: May 1, 2020.



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CAMPER LAST NAME *
CAMPER FIRST NAME *
ADDRESS *
CITY *
STATE *
 ZIP CODE *
HOME PHONE *
CELL PHONE
WORK PHONE
E-MAIL ADDRESS
GRADE *
AGE *
Are you currently a registered Girl Scout? *
HAVE YOU EVER ATTENDED GIRL SCOUT CAMP? *
IF YES, WHEN?
WHY DO YOU WANT TO ATTEND CAMP THIS SUMMER? *
Which Camp are you planning on attending? *
WHAT PROGRAM AT CAMP ARE YOU INTERESTED IN? *
WHAT ELSE WILL YOU BE DOING THIS SUMMER? *
FATHER'S NAME
FATHER'S OCCUPATION
MOTHER'S NAME
MOTHER'S OCCUPATION
TOTAL FAMILY INCOME RANGE BEFORE TAXES *
Enter your total family household income
ANY SISTERS ATTENDING CAMP? *
IF YES, HOW MANY?
TOTAL NUMBER LIVING IN THE HOUSE. *
WHO? *
Signatures
You agree your electronic signature is the legal equivalent of your actual signature on this application.  By selecting the "Submit" button, you are signing this application electronically.
PARENT SIGNATURE *
GIRL APPLICANT SIGNATURE *
Submit
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