| | Part 1: Program Choice |
Please indicate which program you would like to attend (choose only one): |
| 10 Day Mini-Course/s Program (if select, proceed to Part 2a of online application) |
| 6-Week Pre-College Program (if select, proceed to Part 2b of online application) |
Part 2a: If you are interested in the 10-Day Mini-Course/s Program, please one of the following courses |
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Part 2b: If you are interested in the 6-Week Program, please choose three courses below in order of preference |
First Choice Course |
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| Second Choice Course |
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| Third Choice Course |
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| Upon acceptance to the program, you will be placed in one course of your choosing, assuming course and departmental requirements are met. For course descriptions, please see 2008 Summer Sessions Courses. |
Resident Status at Summer Scholars (choose one): |
| Residential Student |
| Commuter Student (Only available to local area residents.) |
Part 3: Student Information |
First Name |
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| Last Name |
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| Address |
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| Address (optional) |
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| City |
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| State |
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| Zip/Postal Code |
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| Country |
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I am a: |
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If Other, please explain: |
Phone |
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| Fax |
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| E-mail Address |
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| Date of Birth |
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| Birthplace |
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Sex: |
| Male |
| Female |
Expected Graduation Date (mm/yy) |
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How did you hear about us? |
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If Other, please explain:
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Part 4: Parent/Guardian Information |
First Name |
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| Last Name |
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| Address |
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| Address (optional) |
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| City |
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| State |
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| Zip/Postal Code |
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| Country |
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| Home Phone |
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| Work Phone |
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| E-mail Address |
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Part 5: High School Information |
School you currently attend |
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| School Address |
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| City |
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| State |
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| Zip/Postal Code |
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| Country |
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| Additional Comments (optional) |
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| | By submitting this form, you certify that the information provided on this application is complete and accurate. |
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