THURSDAY, JANUARY 19, 2017

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* 1. Contact Information:

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* 2. Emergency contact during the program (in the US, if possible):

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* 3. Contact information starting January 3, 2017 (if you can’t be reached at either of the above phone numbers):

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* 4. Track preference: 

Please indicate a first AND second choice. You may only attend ONE track. If we cannot give you your first choice, we will try to give you your second choice if you have made one.

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* 5. If you have any health (e.g., allergy) or mobility issues we should be aware of, please describe:

Transportation will be provided by the Lazarus Center from campus to Boston and back.  You are not required to take the transportation offered by the Center if you have your own, or are already in Boston.

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* 6. Will you need transportation from campus to Boston on January 19?

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* 7. Will you need transportation from Boston to campus on January 19?

Fees:

Students accepted to the program must pay a non-refundable $25 program fee to the Lazarus Center by Friday, December 2, at 4pm.  Cash only please.  NOTE:  If the fee is not paid, your place will be given to another applicant.

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* 8. Application procedures:

Below, please include a 200-word statement explaining why you want to participate in Career Tracks, why you’ve selected your first choice track (and second choice if we are not able to give you your first choice), and what you hope to gain from the program.

There will be a required orientation meeting on Tuesday, December 13, from 12:15-1pm in Campus Center 103-4.
Applicants will be notified of their acceptance to the program via email.

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