Step 1 of 4 25% Introduction The mission of the Special Education Foundation is to assist children with disabilities served by Special School District in St. Louis County achieve success in areas not supported by tax dollars or United Way. The “Kid-to-Camp” program is one of the Foundation’s most successful programs. Through this program, the Foundation provides financial assistance to parents so their child can attend summer camp. Special Education Foundation understands that bridging the instructional gap between summer and fall is critical and that the additional expense of a summer camp can be a burden for many. To that end, SEF picks up where tax dollars stop - providing camperships to students served by the Special School District of St. Louis County. Application Requirements: Campership awards are based on financial need and student benefit. The application MUST be complete. Parent/guardian signatures and statement of financial need is required. A copy of pages 1 and 2 of parent/guardians(s) most recent 1040 tax form must accompany the campership application. Two letters of recommendation are required – one must be from student’s SSD teacher. Funding is for the camp fee only. Registration fees are not included. Selection Process: Submission of an application does not guarantee funding. Maximum amount for a campership award is $650.00. Parents will be notified and checks will be mailed by the end of April. A committee uses a nine-point system to determine campership awards. Point System Letters of recommendation..................................one to three points Benefit to student.................................................one to three points Financial Need.......................................................one to three points Two Letters are required. One must be from the student’s SSD teacher. Your most recent tax return (pages 1 and 2 of Form 1040) must be uploaded. Please white-out all social security numbers on the tax return. Questions? Email Jeanine Aubuchon at jeanine@sef-stl.org or call Jeanine at 314-394-7030. NOTE: You can save your progress on this form and return within 30 days to finish your submission. Just click "Save and Continue Later" to use this feature. ALL APPLICATIONS MUST BE SUBMITTED ONLINE! Click here for a PDF preview of the form questions. Applicant's InformationName of Student* First Last Home Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Parent or Guardian's Name* Parent or Guardian's Email* Parent or Guardian's Work/Cell Phone*Parent or Guardian's AddressIf different from that of the applicant. Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Applicant's SSD InformationSchool* District* Grade Level* Name of SSD Teacher* First Last Teacher's Email* Teacher's Voice Mail* Check your child's diagnosed disability.* Autism Spectrum Hearing Impaired Other Health Impaired Learning Disabled Physically Impaired Vision Impaired Speech/Language Impaired Developmentally Disabled Is your child's ability to communicate impacted by his/her disability?* Yes No Please describe how your child's ability to communicate is impacted.* Camp InformationName of Camp or Program* IMPORTANT: If Campership is awarded, a check will be made payable to the camp name listed above. CHECKS WILL NOT BE REWRITTEN.Camp Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Camp Phone Number*Cost of Camp Tuition Per Week* Length of Camp (Weeks)* Dates Applicant Wishes to Attend* Describe the camp.*Explain the benefit of the camp.*Statement of financial need (completed by parent or guardian).* Please upload the following files. All are required.Pages 1 and 2 of Parent or Guardian's Most Recent 1040 Tax Form*Accepted file types: pdf, doc, docx, txt, rtf, Max. file size: 20 MB.Letter of Recommendation from SSD Teacher*Accepted file types: pdf, doc, docx, txt, rtf, Max. file size: 20 MB.Second Letter of Recommendation*Accepted file types: pdf, doc, docx, txt, rtf, Max. file size: 20 MB.Parent or Guardian's Signature*
