EmailMeForm
GSOC Campership Application
Every camper should have the opportunity to attend camp, regardless of their financial situation. Camperships are specific for those Girl Scouts that are registered with a current GSOC membership. In order to secure your campers spot, please make sure that the deposit has been paid for the desired camp session. Please fill out the campership completely, incomplete campership applications may result in a delay of processing and consideration. Camperships are not guaranteed to cover the full amount. Any remaining balance after financial assistance is awarded must be paid in full by the registration deadline for that specific camp to attend.
Date Time
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MM
/
DD
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YYYY
Please select the camp program for assistance
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Please select
Camp Scherman Summer Sleepaway Camp
Camp Scherman Weekend Camp
GSOC Day Camp
Campers Full Name
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First
Last
Parent/Guardian's Full Name
*
First
Last
Address
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Street Address
City
State / Province / Region
Postal / Zip Code
Phone
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Email
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Campers Current Grade
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Is camper currently a registered member of Girl Scouts of Orange County?
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Please select
yes
no
What level?
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Please select
Daisy
Brownie
Junior
Cadette
Senior
Ambassador
Troop Number If your camper is a Juliette please write Juliette
*
Campers age
*
Campers date of birth
mm/dd/yyyy
*
Program camper is registered for
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Session camper is registered for
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Please select
Session 1
Session 2
Session 3
Session 4
Session 5
Session 6
GSOC Day Camp
Weekend Camp
Dates of camp session
Number in household
# of children registered Girl Scouts
Children's ages
Family’s household total annual income from all sources: (All information is CONFIDENTIAL and
must be filled out completely to be considered.
Please select
Below $10,000
$10,001 - 20,000
$20,001 - 30,000
$30,001 - 40,000
$40,001 - 50,000
$50,001 - $60,000
$60,001 - 70,000
$70,001 - 80,000
$80,001 - 90,000
$90,001 or above
A. Cost of the camp session*
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B. Contribution Breakdown
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Amount from family
Cookie Dough/OC Bucks
Other earnings from Girl Scout
Total contribution
C. Balance Due
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Balance Due (subtract B from A ):
Amount requested from Campership:
Has the Girl Scout participated in the Girl Scout Cookie Program or Fall Sales event?
Please select
Yes
No
Has the Girl Scout received a Campership before?
*
Please select
Yes
No
Amount and date
What specific conditions exist in your family that makes financial assistance necessary (i.e., unusual medical expenses, unemployment, illness, etc?
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How will the camper benefit from this experience?
*
