Max and Marion Caldwell Foundation Campership Application Application Deadline: November 15th. You MUST have secured a spot at Gold Arrow Camp before you apply for this campership. 1 Camper Information2 Application Questions Camper's NameFirst*MiddleLast*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Enter Email Confirm Email Camper's Date of Birth* Please note age restrictions for scholarships.Gender*MaleFemaleGrade in School This Year*KindergartenFirstSecondThirdFourthFifthSixthSeventhEighthNinthWho does camper live with?*Both parentsFatherMotherGuardian or other parentsStepmotherStepfatherOtherLives with other:*Parents are:MarriedDivorcedSeparatedOtherParents other:*Mother/Stepmother/Guardian Name* First Last Mother/Stepmother/Guardian Phone Number*Father/Stepfather/Guardian Name* First Last Father/Stepfather/Guardian Name Phone Number*Alternate Parent/Guardian Address if not the same as camper Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Name of Sibling 1Birthdate of Sibling 1 Name of Sibling 2Birthdate of Sibling 2 Name of Sibling 3Birthdate of Sibling 3 The Max and Marion Caldwell Foundation camperships are a cooperative effort between the Foundation, the participating camps and the camper's family. The Foundation believes that by asking the family to participate financially, each partner is investing in the future of the selected camper.Manny Vezie Campership/Jean N Vezie Campership Pays 80% of the tuition for a child to attend GOLD ARROW CAMP for a two week session for 1 summer. The applicant can be 6-14 years old. References Campership applicants must submit 3 referencesName of First Reference* First Last Relationship*Phone Number*Email Address* Enter Email Confirm Email Name of Second Reference* First Last Relationship*Phone Number*Email Address* Enter Email Confirm Email Name of Third Reference* First Last Relationship*Phone Number*Email Address* Enter Email Confirm Email Signature Approval* By checking this box and typing my name below, I am electronically signing this form. Signature* * Indicates response required Camper's Application QuestionsApplicant Name* Contact Email* Enter Email Confirm Email Please respond to the following questions:Why would you like to go to camp?*How would you describe yourself?*What do you like most about school and why?*What is the most difficult thing you have ever had to do?*Who is the person you most look up to, and why?*Camper's Signature* Parent/Guardian, please respond to the following questions:What is your family circumstance that might qualify you to apply for a campership?*Why do you feel a camp experience would help your child?*Financial Responsibility Parent/Guardian to completeCurrent gross income:*Income or support from all other sources:*The Max and Marion Caldwell Foundation shall not be liable, nor held responsible for any injury, death, loss or damage to any person or property associated with the default of any person, company, or association providing accomodation or transportation connected with the Campership.By signing below, I agree to pay 20% of the camp's current year's tuition. I realize this campership is only for tuition and I will pay for all travel and incidental costs.By signing below, I give permission to the Max and Marion Caldwell Foundation and related camps to use my child's letters, application, name and photo. Signature of Parent(s)/Guardian(s):Signature Approval* By checking this box and typing my name below, I am electronically signing this form. Signature* Signature Date* How did you hear about the Max and Marion Caldwell Foundation?*Accepted file types: pdf, doc, docxPlease attach or send a copy of your child's most recent Report CardAccepted file types: pdf, doc, docx, jpg.Accepted file types: pdf, doc, docx* Indicates response required This iframe contains the logic required to handle Ajax powered Gravity Forms.