Summer Conference 2017
APPLICATION FOR SCHOLARSHIP
Please print & complete this application form, following the instructions at the bottom of the page, and
turn it into your campus staff. This does not take the place of the camp/conference registration form
which must be submitted, with the registration fee ($100), to your campus staff or small group leader.
Because there are many applicants, there is no guarantee of the amount of the scholarship.
Questions? Contact Esther ([email protected]).
Please print all information clearly.
U.S. Student
International Student
Freshman
Sophomore
Junior
Senior
Graduate Student
Name of Camp/Conference
Summer Conference 2017
Name
College/University
Home Address
Address at School
City
State
Zip
( )
Home Telephone
Reason(s) for needing financial aid:
City
Dates
June 18-24, 2017
State
( )
School Telephone
Reason(s) for wanting to attend camp/Conference:
Amount Requested: $___________ (max. $250)
Date of Application: ______________________
Applicant’s Signature
DO NOT WRITE BELOW THIS LINE
Campus Staff Member’s Recommendation:
Amount Recommended: $_____________________
Date: _________________________
CSM Signature
Instructions for Summer Conference Scholarship Form
 Complete the online registration at https://tinyurl.com/summer-con-17
Scholarship form will not be considered without registration and deposit.
 Fill out this scholarship form, and please be SPECIFIC in writing your reasons.
 Submit the $100 deposit to the registrar along with this form by June 1.
We will give you a response by June 8! We look forward to having you join us!
Zip