Page 1 of 4
2517 Highway 35
Building H, Suite 205
Manasquan, NJ 08736
Phone: 732-282-0150
Fax: 732-282-0151
www.CampExcel.com
Scholarship Application
Thank you for your interest in applying for a scholarship to participate in Camp Excel. Please complete
the application in its entirety and submit by the deadline, April 1, 2015
Incomplete applications and those submitted after the deadline of April 1, 2015 will not be considered.
Scholarship Information
Camp Excel will award two $3,500.00 scholarships. Scholarships will be awarded based on
significant, documented financial need. Parents will be responsible for the
remaining balance of tuition by May 30. The balance must be paid by May 30 or
the scholarship will be awarded to another applicant.
Criteria






Children must be between 4-17 years old
Children must be high-functioning, do not have significant cognitive delays and do not have
significant behavioral issues. Please refer to our website www.CampExcel.com for more
information about our program.
Families must demonstrate financial need for consideration. Documentation of financial need
will be required for finalists. (Tax returns, pay check stubs, bank statement, etc.). Please do
not send documentation unless you are notified that you have been selected as a finalist.
All information included in applications will be kept confidential.
Scholarships are open to returning campers as well as new campers.
Past recipients of Camp Excel Scholarships are not eligible for three years after receiving a
Scholarship.
How to Apply
Applications must be postmarked by April 1, 2015. Scholarship finalists will be notified by May 1 to
schedule interviews. Finalists must be available for interviews between May 1 and May 7. Scholarships
will be awarded May 10.
Submit Completed Applications to:
Camp Excel
2517 Highway 35
Building H, Suite 205
Manasquan, NJ 08736
Page 2 of 4
2517 Highway 35
Building H, Suite 205
Manasquan, NJ 08736
Phone: 732-282-0150
Fax: 732-282-0151
www.CampExcel.com
Scholarship Application Form
*Incomplete applications will not be considered*
Child’s Name____________________________________________________________
Address_________________________________________________________________
City_________________________________ State__________ Zip______________
Child’s Date of Birth________________ Child’s Diagnosis______________________
Parent/Guardian Name(s)___________________________________________________
Home Phone___________________________ Work Phone________________________
Cell Phone_____________________________ Email____________________________
Does your child fit the criteria for Camp Excel? (see page 1)
Type of School Placement: (check all that apply)
____ Regular education / Mainstream program
____ Inclusion Class
____ Self-Contained Class
____Special Education School
____1:1 assistant/paraprofessional provided
___Yes
___No
Page 3 of 4
Why do you feel your child would benefit from Camp Excel?
(Do not exceed space provided. Anything written beyond one page will not be read.)
________________________________________________________________________
________________________________________________________________________
_______________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_________________________________________________________________________
Page 4 of 4
Scholarships will be awarded based on significant financial need. It is the goal of the
Committee to award scholarships to those who may not otherwise have the opportunity to attend Camp Excel.
Number of adults living in the household____ Number of children living in the household____
Parent/Guardian #1 occupation_______________________________________________
Parent/Guardian #2 occupation_______________________________________________
What are all of the sources and gross amounts of monthly family income? (REQUIRED:
Application will not be considered without this information)
Parent/Guardian #1_____________________________________________________________
Parent/Guardian #2_____________________________________________________________
Other Income__________________________________________________________________
Other Income__________________________________________________________________
Other Income__________________________________________________________________
Are you receiving or have you applied for other funding for Camp Excel?
If yes please list funding sources:
___Yes
___No
________________________________________________________________________
________________________________________________________________________
Please describe any other circumstances that might affect your family’s ability to send your child
to camp this year.
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________