Welcome Parents!
Financial Aid Application
What is the Campers first & last name? *

What is the Campers full address? *

Street / City / State / Zip Code
What is the first & last name of the Custodial Parent/Guardian? *

Custodial Parent/Guardian's Phone Number? (xxx) xxx-xxxx *

What is your family’s gross income? *

Please explain your need for assistance. *

Are you or anyone in your family past camp participants? *

If yes, you or someone in your family were past campers, please list the number attended and number of years?

Amount Requesting? *

Have you contacted anyone else for sponsorship? *

If Yes, who have you contacted (i.e. local Sertoma Club or Lions Club)?
Has Sertoma sponsored you before? *

If your answer is yes Sertoma has sponsored you in the past, please list what years.

AGREEMENT:  By signing this Electronic Signature Acknowledgment Form, I agree that my electronic signature is the legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my electronic signature or claim that my electronic signature is not legally binding. *

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