2022 ICOO Karl E. Kelley Camp Scholarship Application

ICOO Karl E. Kelley Camp Scholarship Application Form

THIS APPLICATION IS FOR A SINGLE 2022 CAMP SCHOLARSHIP

To be considered, this application must be received by the foundation administrator no later than 11 PM EDT May 15th, 2022.

Complete the form fields below. All fields marked with an * are required. Then click “Preview” to review the entered information.   From the Preview page you can go back to the form to correct any information.  After you complete the information and it is accurate, click “Submit” at the bottom of the Preview page. 

The site will send a validation email to the email address you entered on the form.  You MUST respond to this validation email within 5 minutes or your submittal will not be sent or received!!!

When you click on the link contained in the validation email, you will receive a second email confirming receipt of your scholarship application. Please keep the confirmation for your records.

IF YOU HAVE ANY ISSUES COMPLETING AND SUBMITTING THE FORM, PLEASE CONTACT THE ADMINISTRATOR AT:

administrator@iamdjfoundation.org 

Submitting an application does not guarantee selection and/or award of the scholarship.  Submitting an application does not register the applicant for the camp. The selected scholarship recipient will be contacted directly by the site administrator and provided further instructions on how to register for the camp. The scholarship funds are paid directly to the ICOO KEK Camp. The scholarship covers the camp registration fee ONLY. No funds are provided to the applicant or other party for any other purpose or use.

1. Enter and Preview Information
2. Submit Application

Company

This section is for the parent or guardian of the scholarship applicant to complete.

Title of Parent or Guardian

Choose One Mr. Ms. Mrs. Prof. Dr.

First Name of Parent or Guardian *

Last Name of Parent or Guardian *

Email Address of Parent or Guardian *

Contact Number of Parent or Guardian *

Alternate Contact Number of Parent or Guardian *

Mailing Address Number and Street Name *

Mailing Address City *

Mailing Address State *

– Select Province/State – Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Mailing Address Zip Code (5 digit) *

Please review our Privacy Policy (opens in a new tab)

I have read and agree with the privacy policy regarding this application *

I AGREE I DO NOT AGREE

This section is for the scholarship applicant to complete.

Title of Applicant

Choose One Mstr. Ms.

First Name of Applicant *

Last Name of Applicant *

Grade in School NEXT School Year *

Choose One 6 7

Name of School System Attended LAST School Year *

Name of School Attended LAST School Year *

Name of Home Room Teacher LAST School Year *

Date of Birth *

Present Age (years) *

Reason or reasons you want to attend the ICOO KEK Camp *

How did you learn about our KEK Camp Scholarship? *

Upload a File (optional)

Add Files If you have additional files you wish to share you can upload them here. PDF, jpg, txt, doc, docx formats are permitted.

Information Summary