Scholarship Application

If you wish to be considered for a need-based scholarship to the August 25–28,  2018 session of T1D Buddy Camp, please complete this application before July 15, 2018. All fields with an * are required. 

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)
$