Application for Scholarship
(Please fill out one form for each child)
Child’s Name: ___________________________________________________ Date of Birth: ____________________
Parent/Guardian Name: ____________________________________________________________________________
Address: _________________________________________________________________________________________
City: _______________________________________________________ State: ___________ Zip: ________________
Parent/Guardian E-mail: ____________________________________________________________________________
Phone:___________________________________________________________________________________________
School your child is currently attending: ___________________________________________ Grade: _________
Is your child approved for the Free or Redu
ced Lunch Program, SNAP, or HUSKY?
____ YES ___ NO
Please provide a copy of the document confirming approval with your application.
If your child received a SoundWaters scholarship in the past, please indicate for which program(s):
□ Young Mariners Academy Year(s) attended________________________________
□ Camp SoundWaters Year(s) attended________________________________
Program you are applying for in 2022:
□ Young Mariners Academy
□ Camp SoundWaters: Preferred week ______________________________________________
(One week per applicant, e.g. Bluefish #3 )
I certify that all of the above information is true and correct.
Signature: ________________________________________ Date: _________________________
Please submit this Application with the proof of eligibility by:
- Email: scholarship@soundwaters.org or
- Fax: (203) 967-8306 or
- Mail: SoundWaters Summer Scholarship,1281 Cove Road, Stamford, CT 06902
Please allow 7 business days for your application to be processed. We will contact you via the e-mail provided in
this application. If a scholarship is granted, a non-refundable registration fee will be required during online
registration: $30 for Camp SoundWaters, $150 for Young Mariners Academy.
SoundWaters • 1281 Cove Road • Stamford, CT 06902 • (203) 406 3306 • Fax (203) 967 8306
www.soundwaters.org
