USTA MS SUMMER TENNIS CAMP SCHOLARSHIP PROGRAM DONATION FORM
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USTA MS SUMMER TENNIS CAMP SCHOLARSHIP PROGRAM DONATION FORM

Thank you for your continued support of the USTA Middle States Tennis Camp Donation Scholarship Program.

Just as it has been in past years, in 2011 dozens of deserving youngsters were given the unique opportunity to attend a summer tennis camp, free of charge, through the USTA Middle States Tennis Camp Scholarship Program. To continue this wonderful tradition in 2012 we are asking you to consider providing a young tennis player with an experience he or she could not otherwise afford. Here are the specifics:

1. USTA MS Camp Scholarship donors agree to the following:
A. Donating the tuition cost of one session or one week of your camp.

2. In Return, USTA MS provides camps with the following:
A. A listing of your camp on the USTA MS website which is referenced by the USTA Middle States staff when receiving inquiries about camps.
B. Processing of camp applications and selection of candidates.

If you are interested in participating in the USTA MS Camp Scholarship Program, please complete the form below no LATER THAN MARCH 31, 2012.

Any comments or concerns please contact the USTA Middle States office at 610-935-5000, ext 238 or email Kitty Perrin at kperrin@ms.usta.com

Thank you.

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Would you like to donate a scholarship(s)

Would you like to donate a scholarship(s) YES - I would like to donate a scholarship(s). Please continue below

NO - I do not wish to donate a scholarship at this time, but keep me on the list for future opportunities.

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Please complete the following for the CAMP DIRECTORY listing on the USTA Middle States website.

Please complete the following for the CAMP DIRECTORY listing on the USTA Middle States website. Camp Name:
Camp Contact's Name:
Camp Contact's Email:
Camp Address:
Camp City, State & Zip Code:
Camp Phone #:
Camp Fax #:
Camp Website:

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Please list the number of scholarships you are donating.

Please list the number of scholarships you are donating. # of Day:
# of Overnight:
Ability Level:
Boy/Girl:
Age:
Session Dates:
Other:

Please list any restrictions on entry into your camp (ie. NCAA Regulations, religious, etc).

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Location(s) of your Camp.
Please fill out for all locations. If you have more than 3 locations, please continue with the location addresses in the comment section.

Location(s) of your Camp. Please fill out for all locations. If you have more than 3 locations, please continue with the location addresses in the comment section. 1. Location Camp Name:
Street:
City:
State:
Zip Code:
2. Location Camp Name:
Street:
City:
State:
Zip Code:
3. Location Camp Name:
Street:
City:
State:
Zip Code:

ADDITIONAL Location information for more than 3 locations:

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Thank you for donating a tennis camp scholarship.

Thank you for donating a tennis camp scholarship. Person Completing this Form:
Phone Number:
Date:

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