Boy Scout 2018 Campership Application

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Boy Scout 2018 Campership Application Sagamore Council, BSA PO Box 865 Kokomo IN 46903 765-452-8253 765-459-5625 (Fax) sagamore.council@scouting.org

Name: DOB Address City State Zip Phone number Unit number District: Peshewa rth Star Wabash Valley School System: Do you receive reduced or free lunches within your school system? Number of family members in house Household Income (Please indicate one below): Under $20,000 Between $40,000-$50,000 Between $20,000 - $30,000 Over $50,000 Between $30,000 - $40,000 Which week of Boy Scout Resident Camp will you be attending: Boy Scout Resident Summer Camp Week 1 (June 10-16) Week 2 (June 17-23) Week 3 (June 24-30) Week 4 (July 1-7) Camperships are ONLY for registered Scouts and will be allotted under the direction of the Council Camping Committee to families who need the help. A Scout can attend only one week of camp during the summer. In the event that the Scout does not show up at camp for the start of his registered session, a Show Fee of $25 will be deducted from the fees paid by the parents or others; any campership portion of camp fees is non-transferable and is not refundable to the youth or his unit. Parent Signature: Parent Email Address: Leader Signature: Leader Email Address: (District Executive) (Campership Committee Representative)

All campership applications must be submitted, approved and received at the Council Office by May 1, 2018. All signatures are required for applications to be considered. The campership program is to help an individual member attend Camp Buffalo Resident Camp, Cub Scout Day Camp, Adventure Resident Camp and other Sagamore Council sponsored camping activities, after all other sources of funding are exhausted. It is expected, that a Scout participate in Council Popcorn sales to help raise funds. The Scout is also expected to participate in Community Service Projects fulfilling the Scout Oath & Law. Failure to do so will likely result in a substantially reduced campership amount returned back to the Scout. Did this Scout join Scouting after August 1, 2017? If no did he advance in Rank in 2017? Did you participate in Council sponsored Popcorn sales? Sold $ Did you participate in any Unit sponsored Fundraisers? Event/fundraiser: Sold? $ Did you participate in Scouting for Food or a food drive of any type? Number of items or pounds collected: Did you participate in Goodwill Good Turn Drive? Number of boxes or bags collected: List any Community Service Projects or Contributions your Scout has made to your charter partner or community: Total hours spent by all on the service project: Does this Scout have brothers in the Scouting Program?

Camp Fee (Camp Fees Vary With Each Camp) Example: Camp Buffalo Boy Scout Resident Camp $250 Applicant Can Pay Unit Will Pay Others Can Pay (Unit/ Charter Partner Support) Requested $100 $50 $25 $75 $250 Box A Box B Box C Box D (Required) Complete Boxes A, B C & D Above: Parent Obligations: 1. Pay reservation fees (non-refundable). Reservation deposit ($100) must be paid to the unit or Council before the campership will be approved. 2. Register the boy in the Pack/Troop through which he is applying for the campership before the campership is applied for. 3. Obtain and complete the camp required medical form. Class 1 & 2 National BSA Physician signed physical required for any camp that exceeds 72 hours. 4. Provide spending money. 5. Provide personal equipment (See Cub Master or Scout Master for list of supplies needed). 6. Pay $ toward the total camp fee. ( more than 50% will be provided for a campership) Council Long Term Camp Responsibilities: 1. Provide health and safety services at camp. 2. Camp provides meals IF residential camping. 3. Camp provides opportunities for swimming, Scout activities, rifle range, archery, hiking and campfires. 4. Provide a campership in the amount of: $. ( more than half of the camp fee will be allotted in the form of a Campership)

(Required) Explanation of Need: This explanation greatly influences the amount approved. Please provide as much detail as possible. Office and Campership Committee Approval Applied for: $ Approved: $ Camping Committee Member: Council Camping Chairman: Council Executive: