Fresh Air Fund Application Form

Would you like to apply to have your child attend a Fresh Air Fund Camp?

Complete this form, and we’ll contact you about potential openings.

Fresh Air Fund Application Form
(month/day/year)
How old is this camper?
Which school did the camper attend this past year?
Put in the format 123-456-7890
Put in the format 123-456-7890
Put in the format 123-456-7890. Include extension if needed.
Include house number and street name, city, state, and zip code. Ex: 43 Hill Street Newark, NJ 07102
Put in the format 123-456-7890. Please include extension if needed.
What is the total income made by entire family?
(If no, put "0" in this field.)
(If No, put "N/A" in this field.)
(Please list all allergens for this child. If No, put "N/A" in this field.)
Reason for recommendation
Include your email so that we can contact you directly