Cougar Quest Scholarship Application

DIRECTIONS:

A. Register for Cougar Quest and submit your $100 deposit. (This will be refunded in full should you not be offered a scholarship and wish to cancel registration.)

B. Please PRINT all information in blue or black ink.

C. Parent and/or guardian must complete all information on this form.

D. Application must be received by April 4, 2008.

E. Attach a copy of your 2007 W2 tax forms and mail application to: Cougar Quest PO Box 641035 Pullman, WA 9913‐1035 FAX: 509.335.4455

F. Completion of this form DOES NOT automatically guarantee a camp scholarship. Scholarships are made on the basis of demonstrated need and the amount of scholarship funds available.

G. Scholarship applicants must be attending Cougar Quest during summer 2008.

H. Applicants will be notified in writing (email or US postal service) of decisions on May 2^nd.

Camper’s Name: ____________________________________ _____________________ __________________________ (Last) (First) (Middle) Address: _________________________________________________________________________________________________ (Street or PO Box) ____________________________________________ _____________________ __________________________ (City) (State) (Zip) Parent’s Home Phone: _____________________ Parent’s Alternate Phone Numbers (work/cell):______________________

Parent’s Email Address:____________________________________________________________________________________

Date of Birth of Camper: _____/_____/_______ Camper’s Age: ______ Grade in School this year: ____________

Camper’s Gender: ( ) Female ( ) Male

Week attending Cougar Quest: O July 13-18 (Grades 7-9) O July 20-25 (Grades 9-12)

Has the applicant attended Cougar Quest before? O No O Yes, if yes what year(s):______________________________

Has the applicant received a Cougar Quest scholarship before? O No O Yes, if yes what year(s):__________________

Reason for the scholarship request:

O Parent(s) or Guardian(s) currently unemployed

O Illness in immediate family, with accompanying financial burdens

O Large immediate family size with minimal income

O Other, Explain:__________________________________________________________________________________________

Family’s contribution for Cougar Quest......................................................................................$___________ (Required) (Family is asking for a: 75%/$431.25 50%/$287.50 25%/$143.75 17.392%/$100.00 scholarship from Cougar Quest

	List all Household Members					Monthly Income
Name (last, First)		Age		Monthly Earnings Job 1 (Before Deductions)		Monthly Earnings Job 2 (Before Deductions)	Monthly Income: Welfare Payments, Child Support, Alimony	Monthly Income: Pensions, Retirement, Social Security
1.				$		$	$	$
2.				$		$	$	$
3.				$		$	$	$
4.				$		$	$	$
5.				$		$	$	$
6.				$		$	$	$
7.				$		$	$	$
8.				$		$	$	$

CAMPER, PLEASE RESPOND TO THE FOLLOWING QUESTIONS.

1. Why would you like to go to camp?
2. How would your family and friends describe you?
3. What is the most difficult thing you have ever had to do?
4. Who is the person you most look up to, and why?

Please use the back of this page if you run out of room.

PARENT/GUARDIAN, PLEASE RESPOND TO THE FOLLOWING QUESTIONS.

1. What is your family circumstance that qualifies you to apply for a camp scholarship?
2. Why do you feel a camp experience would help your child?

Please use the back of this page if you run out of room.

I attest that the information I have provided is accurate to the best of my knowledge and ability, and therefore; this camper should be considered for a scholarship award.

Signature of Parent/Gaurdian:_________________________________________________ Date:_______________________

Signature of Camper:________________________________________________________ Date:________________________

We have done the following:

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Registered for Cougar Quest

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Completed the application in full

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Attached tax returns

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Mail the application paperwork so it arrives on or before April 4^th, 2008