Registration

Scholarship Request

Please fill out the following information to apply for a scholarship for any of Redcloud's programs. You may also download a printable Scholarship Request form (Requires Adobe Acrobat Reader). Scholarship funds are limited, so please submit this only if there is a real need for financial assistance.

Parent or Guardian:
Name (F MI Last)
Occupation
Address
Address
City
State/Prov
Zip/Postal Code
Country
Daytime Phone
Evening Phone
E-Mail Address
Preferred method of contact

Participant Name:
Name (F MI Last)
Age

Program & Dates for which you are requesting assistance:
Camp Name
Dates
Is the participant already registered? Yes No

Briefly state the reason for this request:

This information will be held strictly confidential and will be used only in our evaluation of your request for financial assistance.

Before clicking submit, please review the information that you have entered.