Name:
Age:
Address 1:
Address 2:
City:
State:
Zip Code:
Phone:
Email:
Date Submitted:
Is either parent a Member?      Yes      No
Are you a Junior Member?      Yes      No
Who is your Sponsor?
Is Sponsor a Member?      Yes      No
Are you a current Boy or Girl Scout?      Yes      No
Have you been considered for Conservation Camp in the past?      Yes      No
In the space below, please provide a letter, written by the person who will attend camp, stating their desire or reason for wanting to attend the Conservation Camp.
Please type required letter here.