Scholarship Application - DILLON JUNIOR SAILING

Scholarship Application

* Indicates required field

Child's Name *

Date of Birth *

Parent Name *

Phone *

Email *

Employer *

Job Title *

Are you a single parent with sole financial responsibility for your child? *

Yes No

Please tell us why you feel your child can benefit from the Dillon Junior Sailing Program and why they should receive a scholarship. *

Total Camp Costs *

Amount I am able to pay *

Scholarship Needs *

Submit