Scholarship Application

If you wish to be considered for a need-based scholarship to the June 25–28,  2019 session of T1D Buddy Camp, please complete this application before May 1, 2019. All fields with an * are required. We will send out scholarship award notifications in the first week of May. Your scholarship “copay” will be due by June 1. Note that even full scholarship recipients are asked to pay a minimum registration fee of $25.

IMPORTANT NOTE: If your child received a scholarship in 2018 and did not send a note to thank our scholarship donors, they MUST mail one to the address in the footer below BEFORE May 1 to be eligible this session. If you are not sure, contact Anne at email@t1dbuddycamp.org

Camper's Name *
Camper's Name
Parent's Name *
Parent's Name
(Including wages, interest income, investments, alimony, child support, social security, public assistance)
$
All scholarship recipients are asked to make a modest $25 payment towards each child's registration fee.
$
Are there any special circumstances, permanent or temporary, that make financial assistance necessary at this time?
Secondary Parent Information: If divorced or separated, please fill out the information below. Otherwise, hit the SUBMIT button at the bottom of the form.
Secondary Parent Information: If divorced or separated, please fill out the information below. Otherwise, hit the SUBMIT button at the bottom of the form.
(Including wages, interest income, investments, alimony, child support, social security, public assistance)
$