(Page 2 of 2 pages, Space Flight Adventure Camp Scholarship Application)
Please Type or Print
Student's Name:
 		 _____________________
First		 _________
M.I.		 _____________________________
Last
Student's Age: ___________ 
Email Address: ___________________________
Home Address: _____________________________________________________________
State: _____________ Zip: ___________
Phone: Day___________________  Evening ___________________
School Name: _________________________ City/Town: ______________
Camp Date: _________________________

1. In the space provided, please list two of the major reasons you would like to receive a scholarship to the camp.

 

 

2. Give an example of something you have done in school during the past year that demonstrates your interest in space science.

 

 

 

3. After you graduate from high school, what would you like to do in terms of pursuing more education or a job and career?

 

 

 

4. Briefly describe your economic need.

 

5. Attach a letter of recommendation from your science teacher or your school counselor.

6. The following signatures and dates must be on this scholarship application for it to be considered complete. If any signatures are missing, the application will not be reviewed.

_________________________________
Student		 _______________
Date
_________________________________
Parent/Guardian		 _______________
Date