Camp Kaleideum Scholarship Application Thank you for your interest in applying for a scholarship to Camp Kaleideum. Please be as accurate and detailed as possible in this form. Scholarships can be used for one (1) week of camp at a reduced rate. Please fill out the form for each camper you are requesting a scholarship for in this application. Contact Lindsay Douglas at email@example.com with any questions you may have regarding scholarships. If you are granted a scholarship, Kaleideum requires a non-refundable deposit to ensure your child's registration in camp: $50 per week for full-day camp; $25 per week for half-day camp. Caregiver ContactYour Name* First Last Email* Phone*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 Are you a Member of Kaleideum?*YesNoScholarship QuestionsWhat grade(s) will your camper(s) be rising to this fall?*Which camp location do you prefer?*Kaleideum NorthKaleideum DowntownNo preferenceDoes your family receive any aid listed below?* SNAP WIC TANF Other None Include the name(s) of aid your family receives that is not included in the above question*Do any of your children receive the following aid at school?* Free Lunch Reduced Lunch Preschool Subsidy Other None Name the other type(s) of aid your child(ren) receive(s) at school*What is your total monthly household income?*How many adults are living in the household?*Please enter a number greater than or equal to 1.How many children are living in the household?*Please enter a number greater than or equal to 1.Have you received a scholarship for Kaleideum Summer Camp in the past?*YesNoWere you referred to our Scholarship Program through an organization, shelter, social worker, or other service provider?*YesNoPlease provide the name of the organization or social worker*How did you hear about our Scholarship Program?* kaleideum.org Search Engine From a Kaleideum Staff Member Word of Mouth Other Supplementary QuestionsPlease tell us a little about your family's financial situation.If you received this scholarship, in what ways would it affect your family?What will your camper gain from experiencing Camp Kaleideum?General Release* I understand that this application does not secure a space at Camp Kaleideum and that any scholarship awarded will be sent via separate email. I understand that a non-refundable deposit must be paid to reserve my child's space in camp. I understand that cancellations must be made at least two weeks in advance of my camp start date. If I cancel within two weeks, I may not be able to apply for a scholarship next year.