Summer Camp Application

We are looking for 5 strong women to join this retreat as mentor support. To attend as a mentor, you do not have to have a physical difference but are required to pay the full amount to participate. Mentor applicants will be interviewed and trained with SheLift curriculum prior to the event.
Your Name *
Your Name
This summer camp is designed for women with physical differences – however YOU choose to define that. Please indicate your uniqueness.
Please send a photo of you and your daughter
In what state is your permanent residence?
Payment *
Please indicate the payment plan that's best for you. We expect each retreat participant to engage in fundraising toward the costs of the retreat and will help you do so by providing SheLift information. You may choose to create a crowd funding campaign (like CrowdRise), post on social media, send letters to friends and relatives, etc. There are many options!
What is your total household income? If you are applying for the scholarship, you will need to submit income statements.
Do you qualify for student financial aid? *
If yes, please provide documentation
It is a critical part of our mission not to exclude anyone from this opportunity due to financial restrictions and we work very hard to gather funds necessary to ensure inclusion of all girls in our program. The cost of attending a SheLift retreat is available on a sliding scale fee. Please describe your funding needs, including how much you can afford to pay, how much you plan to fundraise, and how much you would like to request from SheLift. If you are able to provide documentation of financial assistance from another institution, you will be considered for SheLift scholarship.
Emergency Contact Info *
Emergency Contact Info
Please include any additional information or background story.
I understand *
That this cost includes daily meals, activities, ground transportation, and the services of staff. Flights are NOT reflected in the price or at the responsibility of SheLift.
I understand
that I will be sharing a tent with other girls