Scholarships Application for Foster Children

Apply for Camp Scholarships

Before you begin please ensure

your applicant matches our “Who Should Apply?” criteria here.
you have a letter from the applicant’s therapist, social worker, or school adjustment counselor stating why the applicant would benefit from attending the camp or program and why they would be a success

If you have questions or concerns about our criteria, please do not hesitate to contact us for more information.

Apply online or download the application to email, mail, or fax it.

Apply for Scholarships

"*" indicates required fields

Applicant (Camper) Information

Please fill out a separate application for each child for whom you are applying.

Name*

Age*

Is the Applicant an adoptee or foster child?*

History, Background, & Special Needs*

Applicant's history or social/emotional special needs that fit the criteria of the Jason Hayes Foundation. All information will be kept confidential.

Main Contact

Name*

Relationship to camper?*

If other, please describe.

Email*

Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Alternate Contact

Name

Parent/ guardian information is required if not listed as main contact.

Relationship to camper?

If other, please describe.

Phone

Address

Street Address Address Line 2 City State ZIP Code

Household Information

Total Number of People in Household*

Number of Children in Household*

Family Income*

From last year. Include wages, alimony, social security, etc.

Other Relevant Family Information

If there is any other family information that would be helpful for us to know, please include it below.

Camp Information

Please provide some information about the camp you are applying for.

Camp Name*

If the program is not a nonprofit organization and a scholarship is granted, we will require a statement (bill) from the camp before a check is issued stating that the funds are for a scholarship for the named camper and the amount of the reduced fee, if any.

Camp Website*

E-mail adddress of CAMP/PROGRAM to which we can send e-check*

Email:

Camp Address*

Street Address Address Line 2 City State ZIP Code

Program Name*

Number of Sessions Attending?*

Please enter a number from 1 to 20.

Session Dates*

Cost of Camp Per Session*

Excluding transportation, registration, etc.

Is the camp providing a reduced fee or scholarship for all or part of a session? If yes, please describe.*

Total Amount Requested*

Goals of the Camp*

Is the camp geared toward children with behavioral, social and/or emotional difficulties?*

Explain why this camp or program is a good fit for the child and how he/she will benefit from attending.*

Assuming the scholarship will not pay for the entire cost of the program, are there other means to pay for the remainder of the cost? Please explain fully including all other scholarships and/or organizations applied to.*

Please add anything else you feel may be relevant to our decision.

Files

Please attach a letter from the applicant’s therapist, social worker, or school adjustment counselor stating why the applicant would benefit from attending the camp or program and why it would be a success.

Drop files here or

Accepted file types: docx, pdf, csv, xlsx, xls, jpg, png, txt, Max. file size: 50 MB.

Number

Total

Untitled