Summer Mathematics Camp
Application Form
Please print
Name:
_____________________________
______________________________
Last First
What do you like to be
called: _______________________________
Parent(s) name:
___________________________________
Signature of
parent or guardian:__________________________________
Home:
_____________________________________________________
____________________________ ____________
__________
City State Zip
Home Phone: (_____)_______________________
Email:____________________________________
Gender: Male (
) Female ( ) Age:
__________
Grade you are
completing this Spring:________
Mathematics courses
you have completed:
Non-mathematical
hobbies or interests:
Special health or
dietary requirements:
Who have you asked to
write a letter of recommendation?
Name:
____________________________________________________
School:
____________________________________________________
School Address:
______________________________________________
______________________________________________