​Camp Kirkwood
Scholarship Request Form

The East Community Steering Team has funded 10 partial scholarships for the 2023 Camp Kirkwood summer camp season. 
​Please note these stipulations:
·        $100 per child
·        One scholarship for one week of camp only
·        For overnight camp only
·        First come/first served
·        For children/youth of East Community Presbyterian churches
·        Scholarships will be applied by Camp Kirkwood upon receipt of camp registration.
 
Fill out and send to Rev. Nancy Gladden, nancygladden@presbycc.org or PO Box 717, Wallace, NC 28466.
 
**Please print legibly
 
Camper name:        ___________________________________________________
 
Parent name:          ___________________________________________________
           
Phone: _______________________  Email: _______________________________
 
Week of camp registered:          _________________________________________
 
Church name:         ___________________________________________________
 
Pastor or Clerk of Session signature:  ____________________________________