Application Entry

Scholarship Request Form

Questions? Email your CHAOS Staff Leader:
Cedar Falls // Brenna Homewood at bhomewood@orchardhillchurch.org
Grundy County // Danielle Schmidt // dschmidt@orchardhillchurch.org
Waverly // Ken DeCook // kdecook@orchardhillchurch.org

Student's Information

Student First Name

Student Last Name

If student does not have an email or mobile number, please leave blank.

Student Email

Student Mobile Phone

Student School

Student Grade

Home Church

CHAOS Program

Why are you interested in being a part of Ski & Shop?

Scholarship Information

Have you received scholarship assistance from us in the past?

Yes No

If yes, which trip?

If yes, amount received?

Please describe the circumstances surrounding your need for financial assistance:

Will a 25% scholarship meet your financial needs?

Yes No

If not, from a financial standpoint, how much do you think you can contribute for Ski & Shop?

If money was not an issue, which "add-on" would you be most excited about doing?

Ski/Snowboard // Renting Equipment Ski/Snowboard // Owns Equipment Bowling Tubing

Any other Information that would be helpful for us to know?

Parent/Guardian Information

Parent/Guardian Name

Parent/Guardian Email

Parent/Guardian Mobile Phone

Submit Application

REGISTER!

Student Registration

VOLUNTEER!

CHAOS is made possible by volunteers who help us each week. We'd love for you to join our team!

Small Group Leaders

Parent Teams