Scholarship Application Form

* fields are required

Please submit this form to apply for a scholarship for the Nuts and Bolts Academy summer camps.

Camper Information

First Name: *

Middle Name:

Last Name: *

Phone Number: *

Email Address: *

Mailing Address: *

City: *

State: *

Zip: *

Age: *

Upcoming Grade of Camper : *

Race/Ethnicity: *

America Indian or Alaska Native
Asian
Black or African American
Hawaiian or Other Pacific Islander
White

Hispanic: *

YesNo

Gender: *

FemaleMale

School: *

Parent/Guardian Information

First Name: *

Last Name: *

Relationship: *

Parent Phone Number: *

In 100 words or less, please tell us the following:

- Why you are rquesting the scholarship
- Attending this camp
- What career fields you are thingking about going into

Student Statement: *

Upload: *

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