FCPJ Peace Camp Registration Form

Please complete and mail to the specified address

□ Panther Camp (Ages 15-20)

□ Manatee Camp (Ages 10-14)

□ Enclosed is a donation to help sponsor a low-income youth for the camp(s) in the amount of $________.

□ Please contact me as I am interested in volunteering at camp(s). I could be of assistance in the following manner: __________________________________________________________________________

________________________________________________________________________________

□ Call me about scholarship availability.

Name: _____________________________________________________

Address____________________________________________________

City/State/Zip: ______________________________________________

Telephone:__________________________ E-mail: __________________

Return to: FCPJ • P.O. Box 336 • Graham, FL 32042

For more information contact: Bob Tancig, Coordinator

352-468-3295 or fcpj@earthlink.net

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