Dear Parents,

Little Black Pearl Summer “Creativity Camp” staff makes every effort to award financial aid when circumstances require it. The intent of this policy is accomplished by setting fees at rates affordable to the majority of residents in the Chicago and surrounding areas, and by providing financial assistance to those for whom the “Creativity Camp” fees are not affordable. Please note that financial assistance is a limited fund and funds will be disbursed based on applicant’s financial need. Both partial and full scholarships are available. Those that receive scholarships will automatically qualify for extended care scholarships. Receipt of scholarship award(s) in previous years does not determine eligibility for current summer camp year.

Little Black Pearl staff reviews each application in confidence and makes award decisions based on the information you provide in this application. Summer scholarship applications must be postmarked or received in our office on or before May 1, 2017.

Please note that all scholarship applications require submission of the first page of the parents’ most recent 1040 Tax Form, showing Adjusted Gross Income (AGI). Scholarship decisions cannot be made without the required tax information. Based on a review of the application, the program manager will determine financial assistance eligibility. Please note that this scholarship is limited. For any additional scholarship questions, please contact our office.

Campers are eligible for one scholarship per summer. Recipients of 50% (half) scholarships will be invoiced for the reduced priced. For example, $900 (cost of camp) - $450 (50% scholarship) = $400.00 (applicant responsibility). Enrollment is not confirmed until payment is received.

Please fill out the following form COMPLETELY. If you have questions regarding scholarships, please call (773)285-1211 or email Ms. Lisa Juran at ljuran@blackpearl.org. All applications must be postmarked or received on or before May 1, 2017.

Little Black Pearl Summer “Creativity Camp”;                                                                Attn: Lisa Juran, Associate Director                                                                              1060 E. 47th Street                                                                                                  Chicago, IL 60653                                                                                 ljuran@blackpearl.org                                                                                                Office: 773-285-1211, Ext. 312 or Fax:  773-285-1633

 

 

Please complete the form below

Has your child ever received a scholarship from Little Black Pearl Summer Camp? *
CAMPER INFORMATION
Camper Name *
Camper Name
Gender *
Birthdate *
Birthdate
PARENT INFORMATION
Address *
Address
Phone *
Phone
Does your child qualify for the free/reduced lunch program at his/her school? *
HOUSEHOLD INCOME
(Please complete all sections that apply)
$
$
$
$
Employer's Name (if applicable)
Employer's Name (if applicable)
Employer's Phone
Employer's Phone
SCHOLARSHIP INFORMATION
Please select your preference *
Do you need extended care? *
BY SUBMITTING THIS FORM I certify that the above information is true and accurate. I authorize Little Black Pearl (LBP) to use the information provided to consider my child for a summer camp scholarship. I also authorize LBP to verify all information on this form.