Form for scholarship providers

DLBC appreciates your willingness to provide a scholarship. As so many parents are not able to pay the full price for their child’s camp experience, your assistance is a blessing. Please fill out the information requested on the form below. Payment must be rec’d no later than the opening day of the camp being attended. Thank you.

Name of camp to be attended

Camper Name

Sponsor Name

Sponsor Street/Mailing Address

City, State, Zip Code

Sponsor Email

Sponsor Phone:

Amount being provided

Payment Type –

Enter Parent/Guardian contact information for verification (Name and phone #)

Agreement to pay: by completing this form and signing as Sponsor, I agree to pay the amount stated above no later than one week before the camp is to start. Sponsor Signature:

Complete the form and click on the Submit button. You will receive an email showing the information you have provided us. Thank you for your gracious support of campers at DLBC.

If you have any questions please call the camp office at 406 882-4572 or email dickeylakebiblecamp@gmail.com