Merit Award Application

Parent / Caregiver
Name*
First Last
Phone (Daytime)*
Phone (Evening)*
Email*
Address: Same as Participant?*
- Yes
- No
Parent/Caregiver Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Add another Parent / Caregiver?
- Yes
- No
Second Parent / Caregiver
Name*
First Last
Phone (Daytime)*
Phone (Evening)*
Email*
Address: Same as Participant?*
- Yes
- No
Second Parent/Caregiver Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

4. APPLICATION FEE - Please select an option below. You can pay with credit card, check, or apply for a fee waiver.
How would you like to pay your application fee?*
You can send a check for $50 made payable to Philadelphia Outward Bound School. Include the applicant's name and course title in the memo line.

Send check to:

Jennifer Raymond
Philadelphia Outward Bound School
3401 Reservoir Drive
Philadelphia, PA 19121
Application Fee
Price:
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address
Billing Address Billing Address Line #2 Billing City Billing State Billing ZIP Code Billing Country
If the application fee presents a hardship for you or your family, the application fee will be waived. Please contact us to request a fee waiver!
In addition to the application fee, I would like to support Merit Award Scholarships at POBS with an additional donation.
Add a Donation?
- Yes! I would like to donate
Donation Amount

Thank you for your support!
Contributions from individuals, foundations, and corporations underwrite merit award expeditions at POBS. If you would like to support this work with a check, please mail to:

Development Office
Philadelphia Outward Bound School
3401 Reservoir Drive
Philadelphia, PA 19121
POBS is a 501c3 nonprofit organization and your gift may be tax deductible. The official registration and financial information of the Philadelphia Outward Bound Center may be obtained from the Pennsylvania Department of State by calling toll-free, within Pennsylvania, 1-800-732-0999. Registration does not imply endorsement.

Merit Award Application

Step 1 of 5

Applicant Information

Parent / Caregiver

Second Parent / Caregiver