First Name Last Name
Phone Number
Student Email
Which camp are you applying to this summer? LEAD Camp (June 7-13)Field Marine Center (June 21-27)Both
Home Address Street Apt. Number City State Zip Code
School Name Grade Level (2025-2026 school year)
Are you applying for a scholarship? YesNo
Recommending Teacher Information
First and Last Name School Name Subject They Teach Phone Number Email
Parent/Guardian Contact Information
First and Last Name Phone Number Alternative Phone Number (if applicable) Email
Upload Your Application Essay
Upload Your Scholarship Request Essay (if applicable)
Confirm that a parent/guardian has reviewed the information you provided in this application form and that they approve your submission of this application and the attached documents.