UWMC ADVENTURES IN LANGUAGE DAY CAMPS

SCHOLARSHIP APPLICATION

 [Note:  Scholarships are awarded based on economic need as determined by the USDA reduced meal guidelines and other extenuating circumstances (e.g. medical bills). Students / parents will be expected to make some contribution toward their fees.]  

1. Please complete all questions and fill in all blanks.
2. Return this application with a Day Camp registration form no later than July 1.  If you are applying for a scholarship, you are still required to submit the required deposit. We will bill for any fees not covered by the scholarship.
3. Call the Continuing Education Office if you have any questions about the scholarship procedure.  715 – 261 – 6294  

FIRST NAME     LAST NAME

ADDRESS

CITY STATE ZIP

HOME PHONE

PARENT First Name PARENT Last Name

I / We are requesting scholarship funds for the following children:

Name   Grade

Name   Grade

Name Grade

Name Grade

NUMBER OF ADULTS IN FAMILY   Total Number of Dependent Children

Do you qualify for FREE SCHOOL LUNCH? YES   NO

Do you qualify for REDUCED SCHOOL LUNCH? YES NO

If you answered "NO" to the above questions, describe the REASONS you are requesting financial aid. List extenuating circumstances (such as job loss, large medical bills, etc). This will aid us in determining your financial need for a Day Camp Scholarship.

Your ADJUSTED GROSS FAMILY INCOME (from you 2007 Federal Tax Form)