Campership Application

  • We’re glad that you’re taking the time to fill out this campership application. If you'd rather print and fill out this form, you can download a copy here. We believe every child and family should have the opportunity to experience the adventures of summer camp at Camp Lutherhaven regardless of financial situation. Campership eligibility guidelines and additional information regarding financial aid can be found here.We hope you find it easy to fill out. If you have any questions, please contact us at (260) 636-7101.

    Eligibility is based on your income and the number of people in your household. Please fill out the information below and return it as soon as possible. A table showing how much financial assistance you may be eligible to receive can be found here. Please note that gifts will be given out on a first come, first serve basis as funds are available.

    Please note that this form is secure and that the information you provide will be treated confidentially and will be used only for determining eligibility. Your prompt and completed application gives you the best chance of receiving financial assistance. If accepted, you will receive a confirmation for the camp program(s) you are registering. If it is determined you are not eligible or if funds are no longer available, you will be notified by mail or phone and have the choice for your deposit to be returned or continue with the registration process.

  • Contact Info

  • Camper Info

  • Please include all campers for whom you desire financial aid. Add/remove campers by clicking the the +/- icons to the right of a row (bottom on mobile).
    Camper's Full NameDesired Camp ProgramRegistration Status 
    Add a new row
  • Household Names & Income

  • Household names: Please write the names of EVERYONE living in your house regardless of earning income or not. Include yourself, spouse, children, grandparents, other relatives, and any other unrelated people living in your house.

    Income: Include the amount of income (if any) that each household member receivedlast month, before taxes or anything else is taken out. Write it in the appropriate income column based on where it came from. If any amount last month was more or less than usual, write that person’s usual monthly income. To determine monthly income, use the following table: If you receive income…

    WeeklyEnter weekly amount X 4.33
    Twice Per MonthEnter twice a month X 2
    Every 2 WeeksEnter every 2 weeks X 2.15
    AnnualyEnter annually ÷ 12

    Type 1 (Earnings…)
    • Wages/Salaries/Tips
    • Strike benefits
    • Unemployment compensation
    • Workman’s compensation
    • Net income from self-owned business
    Type 2 (Welfare…)
    • Public assistance payments
    • Welfare payments
    • Alimony payments
    • Child support payments
    Type 3 (Retirement…)
    • Pensions
    • Retirement income
    • Social Security
    • Veteran payments
    • Supplemental Social Security Income
    Type 4 (Other…)
    • Earnings from second job
    • Disability benefits
    • Interest/Dividends
    • Cash withdrawn from savings
    • Income from Estates/Trusts/Investments
    • Regular contributions from persons not living in the household
    • Royalties/Annuities/Rental Income
    • Any other moneys that may be available to pay for camp
  • Add/remove members by clicking the the +/- icons to the right of a row (bottom on mobile).
    Full NameType 1Type 2Type 3Type 4Total Income 
    Add a new row
  • If applicable, please comment on any situation over and above what your household income shows. (eg. extraordinary medical expenses or recent loss of job)
  • This field is for validation purposes and should be left unchanged.