Love, Joy, Peace...
Ebenezer AME Church Lincolnville, SC
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Name
(
Required
)
Email Address
(
Required
)
Your Phone Number (
Required
)
Class Leader
Attendees
Attendee 1 Name
Attendee 1 age
Attendee 2 Name
Attendee 2 age
Attendee 3 Name
Attendee 3 age
Attendee 4 Name
Attendee 4 age
Attendee 5 Name
Attendee 5 age
Attendee 6 Name
Attendee 6 age
Cost-• Registration fee: $150 per person
• Number of attendees
• Total registration cost
Hotel rate: $35 per person per night for 3 nights (1=$105 )
Total hotel cost
Transportation Cost $10 per person.
Transportation Cost total
Add $20 a day for food pre person.
Total Food Cost
Total estimated cost summary
• Registration total + Hotel total + Meal total + Transportation total
Total estimated trip cost
Amount of Assistance Requested
•Family contribution
Total assistance requested
Reason for Request
Briefly explain why your family is requesting financial assistance.
Additional Support Needed
• Transportation assistance
• Room-sharing support with another family
• Other
Fundraising Participation
Are you willing to participate in a fundraising event?
Yes
No
Chaperone Interest
Are you willing to serve as a chaperone for up to 5 children?
Yes
No
Agreement
I affirm that the information provided is accurate and that if financial assistance is requested due to genuine need.
Sign and Date
Solve 4 + 8 = ?
Submit
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