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Bridge Builders Full Scholarship Request Form For Non-Michigan Residents Camper Name: ____________________________________________________ Camper E-mail: ____________________________________________________ Grade: ____ T-Shirt Size: ____ Date of Birth: ________ __ Person of color __ White Parent’s Name: ____________________________________________________ Address: _________________________________________________________ _________________________________________________________________ City: _______________________________________ State:____ Zip: _________ Parent’s Phone: ____________________________________________________ Parent’s E-mail: ____________________________________________________ __ I am excited to develop as a young leader for the church and world with a raised awareness and understanding of the realities of racism. __ Please contact me about travel assistance. Please mail/fax/e-mail this completed form to: Living Water Ministries 7898 W. Stony Lake Rd. New Era, MI 49446 (231) 861-4377 (fax) [email protected] Mission Bringing together all of God’s children to experience Christian community, grow in faith, develop leadership skills, and serve others. Vision Create communities centered in Christ to transform lives and the world. 7898 W. Stony Lake Rd. New Era, MI 49446 231-861-4138 231-861-4377 (fax) [email protected] www.elcalivingwater.com
