2019 Barberton Summer Camp Scholarship Application

Dear STEM Summer Camp Scholarship Applicant,

The Soap Box Derby is excited to offer a limited number of scholarships for the 2019 Soap Box Derby STEM Summer Camp! We are providing these scholarships to help children who may not be able to afford the camp otherwise. STEM Summer Camp participants will construct a Soap Box Derby car, race a Soap Box Derby car daily down Derby Downs, design and build a Mini Soap Box Derby car and much more.

Applicant Criteria

Soap Box Derby STEM Summer Camp is for children ages 8-13. Sample characteristics of a good applicant include, but are not limited to:

An interest in a variety of fun, hands-on STEM projects.
Curiosity in or willing to explore Soap Box Derby.
Ability to get along well with others.
A willingness to try new things and meet new people.

To Apply

Application Form - to be completed by the child with a parent/guardian. (This form is below and must be submitted online)

Deadline

The deadline to apply for a 2019 Soap Box Derby STEM Summer Camp scholarship is Friday, May 10.

Notification

We will inform the scholarship recipients by Friday, May 17.

Thank you for your interest in the Soap Box Derby STEM Summer Camp! We hope to see you this Summer!

Child's Full Name *

First Name Last Name

Date of Birth *

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Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

How did you hear about this scholarship? *

Which session of Summer Camp would you like to attend ? *

June 3 - 7 June 10 - 14

How did you hear about the Summer Camp? *

School Name *

School City *

School Phone Number *

Area Code Phone Number

Did someone refer you? If yes, who?

Have you participated in a Soap Box Derby STEM Summer Camp before? *

Yes No

Parent/Guardian's Name *

First Name Last Name

Cell Phone Number *

Area Code Phone Number

Home Phone Number

Area Code Phone Number

Work Phone Number

Area Code Phone Number

E-mail *

Please discuss these statements with your child, and mark his/her response in the appropriate box. *

	Strong Agree	Agree	Disagree	Strongly Disagree
I am interested in participating in a variety of hands-on STEM projects
I am curious and want to explore Soap Box Derby
I have the ability to get along with others
I am willing to try new things and meet new people

Why are you interested in attending the Soap Box Derby STEM Summer Camp at Derby Downs? *

What are your hobbies and interests? *

What part of camp would you be most excited about? Why? *

Signature of Parent/Guardian *

Clear

Date *

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