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Trout Unlimited
Tri-State Conservation & Fishing Camp
APPLICANT INFORMATION FORM
Apply soon. Camp fills early.
Applicant Information
Applicant Name:
Date of Birth:
Applicant Email
(if available)
Parent(s) / Guardian(s) Names(s):
Street:
City:
State:
ZIP:
Telephone:
Email:
Current grade:
Male
Female
Teacher or Counselor Reference
Teacher / Counselor Name:
Title or Position:
Evening Phone (required):
Day Phone:
Email:
Essay
Tell us in 150-300 words:
- Why you are interested in attending the camp?
- What you want to get from the camp experience?
- If selected to attend, what you would do to help make the camp successful?
🛈
Press the SUBMIT button below to send in this form. You will receive an email
from TU Camp within several days to confirm that your form has been received.
For information contact:
Suzanne Malone (571) 641-9705, email
malone@tucamp.org
Paul Kearney (540) 229-0563, email
kearney@tucamp.org
Galen Westman (571) 606-0307, email
westman@tucamp.org
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