Anne Arundel County FCA

Camper's Name

Email:

Parent's/Guardian's Email

Parent's/Guardian's Phone

Street Address

City

State

Zip

Camper's school

Grade (as of Fall 2023)

Name of Church (if you attend one)

Name of FCA Camp

Other camp (not listed)

Sport Choice

Amount you/your family can pay toward camp

Has this camper attended FCA Camp before?

Yes

New Field:

Has this camper received an FCA Scholarship before?

Yes

New Field:

2022 household gross income

List any siblings and grades as of Fall 2023

New Field:

Yes

Please briefly explain why your family needs and FCA Scholarship.

How did you hear about FCA and our summer camps?

Would you be willing to volunteer your time to help at FCA Camp?

Date

Signature

Crownsville, MD, United States

(410) 218-6837

rquarto@fca.org