Online Application

Submitted by Craig Kunkle on Mon, 03/09/2009 - 6:41pm.

This Form is to be used to request presbytery support for youth to attend summer camps. For more information plese view the how to apply page on the Youth section of the Presbytery's website.

Instructions:

If you are a Pastor/Clerk/Church and are receiving this by email. Please take a moment to see if this person is a member of your church. If they are please reply and tell us your name and office in the church so we can validate their application.
Christ's Peace,
Nurture team

Camper's first and last name: *

Parent Guardian Name : *

Email : *

Street Address: *

Address Line 2:

City: *

State / Province / Region: *

Postal / Zip Code: *

Day time Phone: In (xxx)XXX-XXXX format

Phone: * In (xxx)XXX-XXXX format

Current Grade of Camper: *

Age at camp : In month/day/4 digit year format

Camper's Date of Birth: * In month/day/4 digit year format

Please Choose the camp : *

Program/camp Attending : *

Date of Camp/ program : * In month/day/4 digit year format

Total Cost of camp: *

Amount to be covered by Presbytery: *

two-thirds of cost for Presbyterian Camps up to $400, one-half of cost for Level 2 Camps up to $300

Home Church email:

Name of home Church : *

# EmailPastor’s/Clerk of Session e-mail address:

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