Scholarship Request Form

Campership Form

Scholarship Request

Every child deserves a memorable summer camp experience. Camp Agape offers Scholarships on an as needed basis. Please fill out the form below and return to the office by email (campinfo@campagape.org)
or mail to: Camp Agape, PO Box 115, Hickory, Pa. 15340.

Camper Name *

Parents Name

Date of Birth

Address

Phone

Email

Sibling(s)

Program(s) Desired to Attend

Amount Requested

Reason for Request

Amount you can contribute

Have you requested financial assistance from your church or other agencies? If so, please identify the source(s)

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Camp Agape

PO Box 115
72 Agape Road
Hickory, PA 15340

Camp Agape is accredited by the American Camp Association. Admission is on a first-come, first-served basis, and provided regardless of race, sex, color, religious affiliation (you don’t have to be Lutheran to attend Agape), national origin, or handicap condition.