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Camper Name (First & Last)

Date of Birth

Parent/Guardian Name (First & Last)

Email

Phone Number

Please select reason for scholarship

Financial need

Disability

Other barrier:

Please select program & week

I understand that this is a lottery scholarship. Recipients will be contacted by 4:00 pm on June 10, 2022.

Thank you for your application! Good luck!

Location

28 Argyle St
Simcoe, ON, N3Y 1V5

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