Summer Campership Scholarship Fund Application 2024

STOP!!

If you have not applied to the Bergen County Division of Child Care first please stop filling out this applications and apply here:https://www.co.bergen.nj.us/division-of-child-care-resources/apply

If you have applied to the Office for Children and were denied please continue, please note that we will verify your denial before processing your application.

1. Have you applied first through the Bergen County Division of Child Care? *This question is required.

If you have not applied to the Office for Children first please stop filling out this applications and apply here: https://www.co.bergen.nj.us/division-of-office-for-children/apply.

Was your application with the Bergen County Division of Child Care Denied?

Please inquire with the Office for Children regarding Camp Scholarships. The Campership fund is for those who were denied funds by the Office for Children.

Name of Parent(s)/ Guardian
Please note YOU MUST LIVE IN BERGEN COUNTY *This question is required.

First Name

Last Name

Street Address

City

State

Zip

Email Address

Phone Number

Ethnicity (for statistical purposes only) *This question is required.

Please enter an 'other' value for this selection.

Please describe any special needs or circumstances that help explain your need for a scholarship.

Parent(s)/Guardian Employer (Our program assists working families that live in Bergen County only, you must be working to receive scholarship.) *This question is required.

Please upload your last two paystubs.

File: {{filename}} delete

Family Monthly Income (include all income from salary, child support, disability, etc.) *This question is required.

Total family size (include self and any other adults living in the household) *This question is required.

Please list all children in the family and answer each question. Please note we only provide assistance to children aged 3 - 12 years old.

List all children in the household:

Space Cell	Child Name	Child Age	Child Gender	Is the Child Applying for Campership
Child 1	Child 1: Child Name	Child 1: Child Age	Child 1: Child Gender	Child 1: Is the Child Applying for Campership
Child 2	Child 2: Child Name	Child 2: Child Age	Child 2: Child Gender	Child 2: Is the Child Applying for Campership
Child 3	Child 3: Child Name	Child 3: Child Age	Child 3: Child Gender	Child 3: Is the Child Applying for Campership
Child 4	Child 4: Child Name	Child 4: Child Age	Child 4: Child Gender	Child 4: Is the Child Applying for Campership
Child 5	Child 5: Child Name	Child 5: Child Age	Child 5: Child Gender	Child 5: Is the Child Applying for Campership

Camp Information Section
This section must be completed to process the application. The camp must be NJ State Licensed, we do check all camps.

Name and contact of summer day camp (do not leave blank, if you are not sure what camp you are attending, do not submit the application.) *This question is required.

Camp Name

Contact Person

Street Address

City

State

Zip

Email Address

Phone Number

What is the cost of camp per week, per child? *This question is required. This question requires a valid number format.

How many weeks of camp are you applying for aid? *This question is required. This question requires a valid number format.

What is the first week of camp? *This question is required. This question requires a valid date format of MM/DD/YYYY.

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What is the last week of camp? *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar