UD Scholarship Form

Phone number

Birthdate

Grade

UD student(s) name *

How many students are you sending to UD camp this summer? *

Current Employment *

Full time

Unemployed

Part time

What amount can you pay? ($360/student) *

Please tell us why your student would like to attend UD Camp *

Average Monthly income *

Less than $1,000

$1,000 - $2,000

$2,000 - $3,000

$3,000 - $4,000

$4,000 - $5,000

$5,000 or more

Please tell us a little bit about your financial situation and why you are requesting a scholarship *

By checking yes, I understand The Student Responsibility. By checking no, I understand that I am forfeiting my students eligibility to receive scholarship money. *

Yes

No