2015 GROUP WORK CAMP
SCAMP
George Williams College
Williams Bay, Wisconsin
July 30 – August 2, 2015
Sponsored by the International Association for the Advancement of Social Work with Groups (formerly AASWG)
SCHOLARSHIP DONATION FORM
You can sponsor one or more students as an individual, or we can combine your donation with
others to form a small group which will sponsor a student collectively. The pool of scholarship
applicants is large and the number of scholarships will be limited. Applicants will be notified by
June 1 so they can make arrangements for travel. For this reason the deadline for donation is
June 1. Your donation is tax-deductible, and a receipt will be provided promptly.
I/we would like to support IASWG in mentoring the next generation of group workers at
Group Work Camp by sponsoring the attendance of one or more students.
Name(s): ____________________________________________________________
Amount of donation (a full scholarship is $300. per student): _________________
I am part of an organization which matches donations: Yes ___ No ___
The student(s) can thank me by contacting me at: __________________________
Enclosed is my donation of $__________, which I am paying by CHECK or MONEY ORDER, made payable to:
IASWG, Inc., with the notation “Scholarship, Group Work Camp” in the memo line. (Note: All payments by
check must be made on US or Canadian bank accounts and be payable in US funds).
I am making my donation by CREDIT CARD, in the amount of $_________.
Please charge my: Visa / Mastercard / Discover Card / American Express
CREDIT CARD AUTHORIZATION
Name of Card Holder (print) _________________________________
Card Number ________ - ________ - ________ - ________ Expiration Date ____/____
CVC Number is required for Visa or Mastercard __ __ __ (3-digit number of the back of card).
Billing Address of Card Holder ___________________________________________________
Note: Credit charges for this donation will clear under the name IASWG, Inc. This is the name that will appear on
your statement.
To ensure meeting the June 1 deadline, please mail this form, along with payment, to:
IASWG Group Work Camp Scholarships
c/0 Ann Bergart
175 Boardwalk Place, #301
Park Ridge, IL 60068