Please keep the following in mind as you complete this form:
  • To serve the maximum number of children, we generally award up to 50% of the cost of camp. Not everyone will receive this amount though, as all aid is awarded based upon household size and income level and is awarded on a first-come, first-served basis until our funds are depleted.
  • All information is confidential.
  • Please fully complete this form and upload all requested documentation.
  • We ask every family to contribute something to their child(ren)’s camp. Please list the largest amount you feel you can contribute, so we can make the best use of our resources and bring more kids to camp.
  • Application reviews take place in the order they were received. We will notify you as soon as a decision is made.
  • We can make arrangements for payment provided that the final payment is received prior to your child(ren) attending camp.
  • IMPORTANT NOTE: In the event we can offer aid and you accept it, we will send you a confirmation email along with an online link to complete the remaining camp forms. Upon completing the forms, you will be charged a camp deposit of $10/child.
If you have questions, please contact Camp Staff at zieglerparkcamp@gmail.com

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* 1. Parent/Guardian Email Address

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* 2. Parent/ Guardian Name & Address

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* 3. Child(ren) Name(s)

If you are requesting assistance for more than 5 children, please email zieglerparkcamp@gmail.com

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* 4. Please select the following that apply to your child(ren):

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* 5. Please indicate the size of your household:

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* 6. Please indicate your total household income over 12 months:

Income Verification

Please provide support documents for ONE of the following options:

  • Copy of prior year's tax return. Note: If you do not have a copy of your tax return, you may obtain one by contacting the Internal Revenue Service.
  • Copy of your last two pay stubs.
  • Copy of Social Security or Disability checks, or copy of bank statement showing amount of automatic monthly deposit.

If you do not have these documents, you will not be able to complete a scholarship application.

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* 7. Attachment #1

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

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* 8. Attachment #2 (if needed)

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

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* 9. What is the maximum dollar amount you can contribute to your child(ren)'s summer?

This does not guarantee you will receive the amount you ask for, but is a guide for us.

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* 10. Please feel free to provide any additional information which you feel would help us make a decision on your scholarship application. Thank you.

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