APPLICATION  FORM                                                   (TXT file)
Trout Unlimited Tri-State Conservation & Fishing Camp  
Graves’ Mountain Lodge - Syria, Virginia
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                See www.tucamp.org for camp information
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Applicants must currently be in the 8th, 9th, 10th, or 11th grade,
   or will be 13 years old before camp starts.

To apply, either:
   (1) fill out the application form online at www.tucamp.org, 
   (2) fill out the form below including essay and email the file to:
          application@tucamp.org, or
   (3) print this form, fill out by hand including essay and mail to: 
          TU Tri-State Conservation & Fishing Camp
          c/o Suzanne Malone
          14030 Roanoke Street
          Woodbridge, VA  22191

For Information contact:
          Suzanne Malone at (571) 641-9705 or email malone@tucamp.org
          Paul Kearney at (540) 229-0563 or email kearney@tucamp.org 
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Name of Applicant:                          Date of Birth:
Name(s) of Parents(s) or Guardian(s):                                                                                                      
Address
     Street:
     City:
     State:
     Zip:
Telephone:
E-mail:
Current Grade:  [ ] 8    [ ] 9    [ ] 10    [ ] 11    
                [ ] or will be 13 years when camp starts.
                                                       
[ ] Male    [ ] Female 
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Name of Teacher or Counselor Reference
     Name:
     Day Telephone:
     Evening Telephone (required please):
     E-mail:
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Please write a brief statement answering the three questions below.  
If needed, you may use two sheets of paper
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    Why are you interested in attending the camp? 

    What do you want to get from the camp?

    If selected to attend, what would you do to help make the camp successful?










Updated Nov. 18, 2009