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2009 4-H Camp Scholarship Application

Harbor Point 4-H Camp – Mercer County

Families experiencing a financial need are encouraged to apply. This information is held strictly
confidential. No one at camp knows who may have received a discounted camp price. Monies
provided by the Mercer County 4-H Foundation.

Family Name: ____________________________________________________________________

Number of children from this family wishing to attend 4-H camp: ___________________________

Family Address: __________________________________________________________________


(Street) (Town) (Zip)

Phone: (______)_________________________ Email: ___________________________________

Please √ all that apply to your situation:

____ Recent Loss of Employment ____ Currently Laid Off Work

____ Hours at Work Cut ____ Multiple Children wishing to attend

____ Family Illness ____ Other financial hardship

Families will be notified of the amount to pay for each child attending camp. Generally, we will
offer a ½ fee for the child to attend unless you are informed of another amount. If you are registering
close to the deadline, go ahead and send in your camp registration with this form or a note stating
that you have applied for a camp scholarship and include ½ of the normal camp fee.

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