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Work Entry
Request a Scholarship for High School Camp.
Student First Name
Student Last Name
Student Gender
Male
Female
Student Grade (2024-25 school year)
8th Grade
9th Grade
10th Grade
11th Grade
Parent First Name
Parent Last Name
Parent Phone Number
Parent Email Address
My Student Attends the Following Campus:
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
Williamsport
Willow Street
Reason for Scholarship Request
What amount will you be able to contribute to your student's $419 ticket for High School Camp?
Does your student regularly attend HSM?
No
Yes
Does your student serve at LCBC?
No
Yes
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