Summer Seminar on Global Issues

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Application for Admission

First Name *

Last Name *

Gender *

Street Address *

City *

State *

Zipcode *

Cell Phone *

E-mail Address *

Emergency Contact Name *

Relationship to Student *

Emergency Contact Phone Number *

High School *

Grade Level during 2014-2015 School Year *

10th

11th

School/Extracurricular Activities and Offices Held *

Community/Volunteer Service *

Additional activities not previously mentioned (includes summer employment) *

World Affairs Council programs attended *

Approximate grade point average this year *

Are you planning to attend college? *

If so, what major(s) are you considering?

What topics or issues are you interested in learning about during this year's Summer Seminar? *

Please list any special accommodations needed (if any). Please note, this will not affect admission *

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