Tell us About Your Child.

Each child is unique. Our individualized, all-encompassing approach requires that we know as much about your child’s needs as possible before determining proper placement within our camp. Please fill out the attached form to finalize your scholarship submission.

PLEASE NOTE: Your submission is not finalized until this form is completed and your essay has been emailed to scott@westhillscamp.com.

Thank you and good luck!

Finish Your Profile

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Your Name *

Last Name

Email Address *

Child’s Name

Child’s Age

Current School

What type of classroom placement is your child in?

6:1:1
12:1:1
Inclusion

Does your child receive related services?

Yes
No

Is your child:

Able to communicate their wants and needs?

Yes
No

Able to follow directions?

Yes
No

Does your Child:

Respond to questions asked?

Yes
No

Know how to swim?

Yes
No

Need a 1:1 Aide?

Yes
No

Have a special sensory diet?

Yes
No

Have a Behavior Intervention Plan?

Yes
No

Has your Child:

Participated in team sports before?

Yes
No

Been in a camp setting before?

Yes
No

Slept away from home before?

Yes
No

Gersh Summer Program is a program of
Gersh Autism