Student Information
First Name Last Name Street or P. O. Address City State Zip Sex: Female Male T-Shirt Size: Select Size adult small adult medium adult large extra large 2X 3X Area Code and Home Phone Number Email Parent Name Parent Phone
First Name Last Name
Street or P. O. Address
City State Zip
Sex: Female Male
T-Shirt Size: Select Size adult small adult medium adult large extra large 2X 3X
Area Code and Home Phone Number
Email
Parent Name Parent Phone
School Information
School Street or P. O. Address City State Zip Publication Adviser 2011-2012 Staff Position 2012-2013 Staff Position Total number of years on staff:
School
Publication
Adviser
2011-2012 Staff Position
2012-2013 Staff Position
Total number of years on staff:
Lodging Options
Commuter ($0) Quad Occupancy ($120) Triple Occupancy ($160) Double Occupancy ($225) Single Occupancy ($425)
Class Registration
Roommate Information
Roommate 1 Roommate 2
Roommate 1
Roommate 2
