Prince George's FCA

Camp Scholarship Request Form

Campers Name:

Parent/Guardian's Name

Address

City

State

Zip

Parent/Guardian's Phone Number

Parent/Guardian's Email Address

Campers School

Grade Entering Fall 2025

Name of Church (if you attend one)

Name of FCA Camp

Other Camp Name-type in the name of the camp not listed

Sport Choice

Amount you/your family can pay to send your child to camp

Has this camper (named in the application) ever been to an FCA camp before?

If so, what year?

Please list any other siblings and their grades (if applicable) entering Fall 2025

Has the camper (named in the application) been involved in FCA in school this past year?

Please explain why your family needs a camp scholarship .

How did you hear about FCA and our summer camps

Would you be willing to volunteer your time to help with our FCA Camps?

Date

Signature

PO Box 5612

Derwood, MD 20855

pginfo@fca.org