To nominate a future camper, please carefully read all the directions and fill the form out completely. Failure to fill out the form in its entirety will result in this application being null. The scholarship cannot be redeemed for cash and only will be accepted at WV BlackHills Teen Camp 2017 or WV BlackHills Children's Camp 2017. Filling out this application does not guarantee a scholarship will be granted to your nominee.

If winning nominee does not accept and agree to attend one of the above camps, an alternate winner will be named in his/her place. Original winning nominee will forfeit their scholarship.

Your Information
First Name is required.
Last Name is required.
Email Address is required.
Phone Number is required and must be in the form: XXX-XXX-XXXX.
Nominee Information
Nominee's First Name is required.
Nominee's Last Name is required.
Children's
Teen Camp to Attend is required.
Nomination Reason is required.