SCHOLARSHIP APPLICATION 4-H Shooting Education CAMP (Instructor’s kids)

DEADLINE – June 10, 2007

Send to

Larry Harris Canter’s Cave 4-H Camp 1362 Caves Rd. Jackson, OH 45640 4-H Shooting Education Camp, July 8 – July 13, 2007

This Scholarship is for the amount of $70.00 toward the $245.00 cost of camp.

Please fill in this application and send to address stated above. 4-H Shooting Education Camp is open to all 4-H members and non 4-H members who are 12 years old by July 8, 2007 with the older age limit being any youth up to 18 years of age allowed to attend as a camper. The Ohio 4-H Shooting Sports Committee is providing a limited number of scholarships. Members who have received scholarships for two previous years will not be eligible for a scholarship unless there are an insufficient number of applicants. Only 4-H members are eligible for scholarships.

NOTE: This Application is for Instructors that are teaching discipline(s) or other activities for the full week at the Ohio 4-H Shooting Education Camp.

Name

Address

City

State

Zip Code

County

Phone

Age

1. Is applicant a member of a 4-H Shooting Sports club? (Check One)

Yes

No

If yes, Club name?

Advisor

2. Has camper attended 4-H Shooting Education Camp before? (Check One)

Yes

No

If yes, how many years?

What discipline (s) did you take?

3. Disciplines I would prefer to enroll in?

1^st

2^nd

3^rd

Families requiring additional financial assistance should complete the more detailed Scholarship Application form. Contact Larry Harris (740) 286-4058 for the application, or print the Application from our website and send to the address listed above. Website: http://www.ohio4hshootingsports.org .

Parent / Guardian Signature

Date

NOTE – Applicants must still register to attend 4-H Shooting Education Camp. This scholarship form does not register you for camp.