Use this application for both work and named scholarships. Name:_____________________Age_____M/F____ Address:_________________________________                ________________________________ City/State/Zip:_____________________________ Phone Home:_____________work:___________	Named Scholarships: Answer questions 1-10 Please try to limit your responses to one page. 5 How much aid do you need? Please give a definite figure for the aid requested; " as much as possible" is not a sufficient answer. Click for Work Scholarship amounts. Work Scholarship   $__________ Named Scholarship + $__________ TOTAL = $__________ 6. Check any named scholarship that you are applying for. Please read Named Scholarship Information first. ____ Ellen Bray ____ Grace Feldman ____ May Gadd ____ Michele Godbout ____ Bob and Kathleen Hider ____ John Hodgkin ____ Jennifer Lehmann ____ Phil Merrill ____ Peter Redgate ____ Karl Rodgers/PMM ____ Bruce Weigold ____ Janie Winkles 7 Have you ever received a CDSS Scholarship? _______ Yes _______ No If yes, for what year(s)_____________________ week(s)_____________________ 8 Are you a full time student? ________ If so, where?
Work Scholarships: Answer questions 1-4 only 1. Applying for:_________________ Week at (circle) PINEWOODS - BUFFALO GAP - OGONTZ. 2 If applying to other CDSS weeks, please list: 3 Check if interested in one of these specific work scholarship jobs. __ Dining Hall Manager __ Certified lifeguard/CPR/1st Aid __ Sound system (professional) __ Doctor/RN (for Family and Campers' Weeks) __ Photographer (professional) __ Babysitter (for Family and Campers' Weeks) __ Other (please specify) 4 Could you attend camp without this aid?________
Please attach this completed application to your camp registration and submit with your deposit for the week.	9 If you are employed/self-employed, please list employment and position; if not self-supporting, please explain.
App Due Rcd Wk Choice Notif WL $ Req $ Grant Work $ $ Named $ $ TOTAL $ $	10 Please list dance, music or school groups in which you actively participate (include your position, if any, as leader, musician, singer, or teacher)