Amazement Square WonderCamp Scholarship Application

Amazement Square
27 Ninth Street
Lynchburg, VA 24504

434-845-1888
www.amazementsquare.org

Amazement Square is excited to offer a limited number of scholarship opportunities for
WonderCamp sessions. These scholarships are primarily need‐based, but we encourage a
demonstration of your child’s interest in Wondercamp such as a drawing, video, or poem, to be
included with the application.

Please submit application at least 5 days before desired WonderCamp’s start date. Limited scholarships available. WonderCamp scholarship applications are accepted throughout the spring and summer.

Camper Information

First Name *

Last Name *

Gender *

Birth Date *

Parent/Guardian Registration Information

Last Name *

First Name *

Address Line 1 *

Address Line 2

City *

State *

Zip *

Phone *

Alternate Phone

Email Address *

Annual Household Income *

Number of People in your Household *

Camp Information

List, in order of preference, the camp(s) your child is most interested in attending. You may list camp themes or dates.

Choice #1:

Choice #2:

Choice #3:

Scholarship Information

We strongly encourage you to include an expression of your child’s eagerness to attend their
preferred WonderCamp. This can be a drawing, song, poem, video, or anything else you can
dream up! This media will only be seen by the scholarship board and will not be released.

Link to Media

You may also email the media to education@amazementsquare.com or mail media to
Amazement Square
WonderCamp
27 Ninth St
Lynchburg, VA 24504

Please list any additional information that may assist in our decision.

Terms and Conditions

Scholarship Application Terms and Conditions
A. Due to a limited amount of space available, filling out a scholarship application does not
guarantee your child a camp spot. Nor does it guarantee a spot in child’s preferred camp.
B. Completed application must be received 5 days before desired WonderCamp’s start date
C. Application and application material will only be seen and reviewed by the scholarship board.
None of the contained material will be released.
D. This is an equal opportunity scholarship. Amazement Square does not discriminate on the basis
of race, creed, color, national origin, ancestry, sexual orientation, gender, religion or disability.
E. This chosen recipient of the scholarship will not be revealed at any time to any of the other
camp participants.

By signing you verify that all information provided is accurate and you agree to the Terms and Conditions.

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If you have any questions or concerns please contact us at 434‐845‐1888
or email education@amazementsquare.org

Amazement Square is a 501(c )(3) nonprofit educational organization registered with the State Commonwealth Comission, Tax ID 54‐1713204

27 Ninth Street Lynchburg VA 24504 Phone (434) 845‐1888
Website: www.amazementsquare.org Email: visitus@amazementsquare.org

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