| Address |
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| City |
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___________________ |
| Phone |
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| Work phone |
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| E-mail |
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| Home Church |
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| Church City |
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| Camp
Program Desired |
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| Housing Preference |
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| 1st
Choice |
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| 2nd
Choice |
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| Roommate
Preference |
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(for
father/son or mother/daughter |
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| Total
Enclosed |
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| Check # |
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Mail to: |
Check here to have a
financial aid packet sent to you |
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Camp
Lutherhaven
1596 S.
150 W.
Albion,
IN 46701 |
| Financial Aid Info - click here |
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| How
did you first hear about Camp Lutherhaven? |
|
Friend/Family Internet
School/Church Other________________________ |
