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Request a Scholarship for High School Camp.
Student First Name
Student First Name is required.
Student Last Name
Student Last Name is required.
Student's Birthdate
Student's Birthdate is required.
Student Gender
Male
Female
Student Gender is required.
Student Grade (2025-26 school year)
8th Grade
9th Grade
10th Grade
11th Grade
Student Grade (2025-26 school year) is required.
Parent First Name
Parent First Name is required.
Parent Last Name
Parent Last Name is required.
Parent Phone Number
Parent Phone Number is required.
Parent Email Address
Email address is not valid
Parent Email Address is required.
What Campus Does Your Student Attend?
Altoona
Center Valley
Clarks Summit
Coal Township
Columbia-Montour
Dickson City
East York
Ephrata
Hanover
Harleysville
Harrisburg
Hazleton
Lancaster City
Lebanon
Leesport
Manheim
Northern Dauphin
Online
Pottstown
Sinking Spring
Waynesboro
West Schuylkill
West Shore
West York
Wilkes-Barre
Willow Street
What Campus Does Your Student Attend? is required.
Does your student regularly attend HSM?
No
Yes
Does your student regularly attend HSM? is required.
Does your student serve at LCBC?
No
Yes
Does your student serve at LCBC? is required.
Tell us a little about your story and the need for a scholarship?
Tell us a little about your story and the need for a scholarship? is required.
How many dependents are in your household?
How many dependents are in your household? is required.
How many Middle and High School students are in your household?
How many Middle and High School students are in your household? is required.
How many scholarships to attend Camp have you received in the past 5 years from LCBC Church?
How many scholarships to attend Camp have you received in the past 5 years from LCBC Church? is required.
What scholarship amount would you need contributed to your student's $455 ticket to High School Camp?
10%
20%
30%
40%
50% or more
What scholarship amount would you need contributed to your student's $455 ticket to High School Camp? is required.
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