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Sterling-Rock Falls Family YMCA
Summer Camp
Camp Benson Photos
Scholarship Application
Program Guide
GIVE
Sterling-Rock Falls Family YMCA
YMCA Camp Benson Scholarship Application
Application for possible scholarship to assist with paying for Camp Benson
Name
(Required)
Phone Number
(Required)
Email
(Required)
Date of Birth
(Required)
Address
(Required)
Emergency Contact Person
(Required)
Under 18? Parent or Guardian Name
How many people are in your household?
(Required)
Adult's Name and DOB
(Required)
2nd Adult's Name and DOB
3rd Adult's Name and DOB
Child's Name and DOB
(Required)
2nd Child's Name and DOB
3rd Child's Name and DOB
4th Child's Name and DOB
I am applying for
(Required)
Do you have any special financial circumstances that we should consider? How will a Y scholarship help you and/or your family?
Upload Qualifying Information
Max. file size: 256 MB.
To Qualify for a scholarship please upload all applicable financial documents:
Current Federal Tax 1040 Form (Quickest method of determination) OR Provide any of the following documents if you do not file 1040 taxes: Rent Assistance, Food Stamps, Birth Certificates/Guardianship Papers (only for children NOT on taxes), Two Current Pay Stubs (For all adults in the household), Unemployment (For all adults in the household), Court Ordered Child Support or Alimony Social Security or Disability (For all adults in the household). If you have no proof of income, you must provide a letter from the personal supporting you and a referral letter from someone not related to you (school, clergy, caseworker, etc.)
