Summer Camp Kindness sessions (three-day sessions June-Aug) Camp Kindness Scholarship Application Post October 2, 2018 Information Child's Name: * Child's Age: * Parent/Guardian's Name: * Address: * Phone Number: * E-mail: * What is your household’s annual income? : * How many people live in your household? : * How many are minors?: * Does your child receive free or reduced-price meals at school?: * Yes No Students: Why would you like to attend Camp Kindness?: * Low-income qualification through the Energy Assistance Program Rate (EAPR) by SMUD or California Alternate Rates for Energy (CARE) program by PG&E (must provide copy of current utility bill with name and address) or proof of CalFresh, EBT, or Parent's Enrollment in Medi-Cal: * I verify that all of the information I have provided above is true to the best of my knowledge. I have not registered my child for a camp session and I have not paid the registration fee: * Yes No Preferred Camp Date: *
