Capturing Dinosaurs 2013

Student Personal Information 1

Application for high school students for the Capturing Dinosaurs 2013. Application deadline is Sunday, June 30, 2013, 5PM.

Program dates:
July 8-12, 15-19 9:30AM - 4PM (please note on Tues, July 9th, the program will have special extended hours, until 7PM).

Please also note that your application is not complete until this entire form is completed. The program will cost $1,100 for the two weeks ($1,050 for members). Full fee waivers are available for this program and requests can be made through this form.

Students will be notified of acceptance/rejection via email no later than Monday, July 1. A letter will be sent out no later than the week of July 1.

(If you want to review details about the program before applying, please go here: http://tinyurl.com/CapturingDinosaursAMNH, or direct questions to Barry Joseph at digitallearningatamnh@gmail.com)

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* 1. Are you able attend all ten day-long sessions within the Capturing Dinosaurs program?

Yes

Other (please specify)

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* 2. Last Name

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* 3. First Name (please do not use nicknames or shortened versions of your given name)

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* 4. Middle Name

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* 5. Date of Birth (MM/DD/YYYY)

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* 6. Age

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* 7. Gender

Male

Female

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* 8. What grade will you be in this fall?

9th

10th

11th

12th

I am graduating this Spring

Other (please specify)

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* 1. Are you able attend all ten day-long sessions within the Capturing Dinosaurs program?

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* 2. Last Name

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* 3. First Name (please do not use nicknames or shortened versions of your given name)

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* 4. Middle Name

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* 5. Date of Birth (MM/DD/YYYY)

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* 6. Age

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* 7. Gender

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* 8. What grade will you be in this fall?

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* 9. Email address