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Scholarship form
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Scholarship form
 

ACBS(IOWA) 2008 Summer Camp - Registration/Scholarship Form

Pine Lake Christian Camp (PLCC)

Name:

 

Age:

 

Gender:     ____ Male  ____ Female

Address:

 

City:

 

Phone:

 

State/Zip:

 

Email:

 

Grade in Fall:

 

Home Church:

 

Pastor:

 

Emergency contact:                                     Phone:

                                                

 

Applying for camp scholarship?  Yes or No (circle one)

[If you circled "Yes" above, please answer the following questions.]

1.      First time at a Christian camp? Yes or No

2.      Needing financial help at this time? Yes or No

3.      Don’t have a home church yet? Yes or No

4.  Referral by youth leaders? Yes or No

Some of the criteria are: First time camper, needing financial help at this time, referral by youth leaders, the un-church..........

ACBS
2723 Douglas Ave.
Des Moines, Iowa 50310