It is one of the core values of Lord Somers Camp and Power House that no one be turned away because of inability to pay. Payment plans are aimed to support applicants to still be able to participate in our programs through financial difficulty.
Full Name

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* 1. Full Name

Contact Number

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* 2. Contact Number

Email address

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* 3. Email address

Program

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* 4. Program

Payment Plan Amount 
(Big Camp Fee: $575.00)

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* 5. Payment Plan Amount 
(Big Camp Fee: $575.00)

I will pay installments of the fee above on the following dates:
(e.g. 23/10/2017 - $25)

(NB: all payments must be finalised by the end of the month that the program occurs in)

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* 6. I will pay installments of the fee above on the following dates:
(e.g. 23/10/2017 - $25)

(NB: all payments must be finalised by the end of the month that the program occurs in)

Payment plans are to be approved by Bruce Simons (CEO).

I understand that if I come into any difficulties paying on the above dates, all I need to do is call the LSCPH office to reschedule payments.

T: 03 9510 7066 E: info@lordsomerscamp.org.au

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* 7. Payment plans are to be approved by Bruce Simons (CEO).

I understand that if I come into any difficulties paying on the above dates, all I need to do is call the LSCPH office to reschedule payments.

T: 03 9510 7066 E: info@lordsomerscamp.org.au

I agree that this Payment Plan is to be made with Lord Somers Camp and Power House for the payment of the program fee in the structure disclosed above until the fee is paid in full.

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* 8. I agree that this Payment Plan is to be made with Lord Somers Camp and Power House for the payment of the program fee in the structure disclosed above until the fee is paid in full.

T