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Scholarship Form for Presbytery Point 2004

(Note: Only 16 -$60 Scholarships and 8 - $25 bonus scholarships are available. Please act quickly!)

Name: ___________________________________

Address: _________________________________

City, State, & Zip Code: _____________________

Phone #: _________________________________

Age: ____________________________________

Grade: ___________________________________

Parent’s Business Phone #: ___________________

I would like to attend with the consent of my parents Presbytery Point Camp Summer 2004. I am applying for a $60 scholarship, and have attended at least 5 church events. (Examples: church service, Wildlife, Impact, Lighthouse Kids, Vacation Bible School, Sunday School, etc.) I agree to conduct myself in a manner that positively reflects God, First Presbyterian Church, and the Lighthouse Youth group. If I do not conduct myself in such a manner, I agree to be sent home early at my parent’s expense. I agree that if I cancel or do not show to camp, my parents and I are responsible to reimburse the church for all scholarships received.

Student’s Signature: __________________________

Parent’s Signature: __________________________

I verify that this student has attended at least 5 church events.

Church Staff Signature: _______________________

New Recruit Bonus: Students can receive a $25 bonus for bringing someone who was not at Presbytery Point Camp in 2003

**My Recruit is: _________________________

(Your new recruit’s forms must in the Church office before the bonus will be given)

Staff Use ONLY:

____: Attached is the Camp Registration Form and final payment.

____: New Recruit has been verified.