Carol Treadwell Scholarship Application

Program*

Name*

First Last

Age*

Gender

Parent/Guardian Name*

First Last

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Home Phone

Cell Phone

Email

To be completed by parent/guardian

How many school-aged children are in your family

Occupations of parents/guardians

Are you applying for a full tuition scholarship?

Partial scholarships are also available. How much are you applying for?

Please describe your family situation and financial need

Why do you want to attend the selected PWSSC summer program? What do you hope to learn?*

What excites you most about science and the environment?*

How do you think your camp experience will continue to affect you after your time at camp?*