SUMMER COLLEGE FOR HIGH SCHOOL STUDENTS - 2007 APPLICATION
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SUMMER COLLEGE FOR HIGH SCHOOL STUDENTS
Application For Admission Summer 2007
Last Name
First Name
Middle Initial
Birth Date
Gender M F
Street
City
State
Zip Code
Country (if not USA)
Telephone ( )
E-mail Address
Social Security Number
High School Name
Street
City
State
Zip Code
Country (if not USA)
Expected Graduation Date
Mother's Name

Address (if different from Yours)
Street
City
State
Zip Code
Country (if not USA)
Home Phone ( )
Work Phone ( )
Father's Name

Address (if different from Yours)
Street
City
State
Zip Code
Country (if not USA)
Home Phone ( )
Work Phone ( )
Are you a citizen of the United States? Yes No
If no, what is your country of citizenship?
Passport Number
U.S. citizens and permanent residents only: Please indicate your racial or ethnic origin (response optional). If multiracial, select the one with which you most strongly identify.
Summer College Three Week Session: July 1 - July 20 (for high school sophomores and juniors). If you sign up for the three week session, you may also register for minicourses.

Three week session students enroll in one college level course for two or three college credits. Indicate your preferences below.

First Choice

Second Choice


Summer College Five Week Session: July 1 - August 3 (primarily for high school juniors). If you register for this session, you cannot register for the three week session or any of the minicourses.

Five week session students enroll in two courses for 6-8 credits. Indicate your preferences below.

First Choice

Second Choice

Third Choice


Summer College Minicourses: July 22 - July 27 (open to all high school students)

Indicate your course preference below.

First Choice

Second Choice


Summer College Minicourses: July 29 - August 3 (open to all high school students)

Indicate your course preference below. 		 

First Choice  

Second Choice  

Note that this is not a "secure transaction." If you are not willing to send this information via e-mail, please print and fax this form to 607-274-1263