Alaska String Camps, Inc.

Elementary Camp application

APPLICATION FORM:

Camper’s Name ___________________________________________________

Mailing Address: Street ______________________________________________

City _____________________________ State __________ Zip ____________

T-shirt size: (Adult sizes) S M L XL Date of Birth: ____ / ____ / ____

School:(04/05) __________________________

Circle Instrument: Violin Viola Cello Bass Total years played: _______

Current Grade in School Year 04/05: 4th 5th 6th Sex: M F

Orchestra Teachers Name: ___________________________________

Do you study privately? YES NO If yes, how long privately? ___________

Are you a member of the local Honor Orchestra? yes ____ no _____

Private Teacher: ______________________________

Parent’s Name: ________________________________

Phone: (Day) __________________ (Eve) ______________________

Parent's Signature ___________________________________________

Email address: _________________________________________________

Office use only: 1 $ ______ 2 $ ______ Elem

Many organizations provide funding to arts organizations and/or scholarships for employees dependents. We would appreciate your indicating an Employer name for each parent/guardian in the home so that we can assess the availability of funding.

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Parents: Join the fun! We need men and women volunteers for both a few hours a day and for overnight stays. Campers whose parents are accepted as an overnight camp chaperone receive a tuition discount. You’ll have lots of free time to enjoy boating, swimming, hiking, volleyball or just sit back and relax while enjoying that favorite book you’ve wanted to read. Enjoy heated cabins, hot showers and free meals. Eagle River is only moments away from camp with specialty coffee shops and boutiques/country stores.

Try it&ldots;..you’ll love it!

  ___ YES ___ NO ___ MAYBE

If yes, or maybe, you will be contacted with detailed information.

Name: _______________________________________________________

Telephone number ________________ (Hm) __________________ (Wk)

Best time to call: _______________________________

If interested in overnight cabin counselor, please indicate: ____ M ____ F

ROOMMATE REQUESTS

We try to accommodate camper’s requests for roommates. Each cabin will house 10 campers and two chaperones. Parents who wish to volunteer as chaperones may indicate whether they prefer to be in the same cabin with their camper. Please write you roommate preference below:

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Print Name(s)

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