Sponsor: Advanced Self-Powered Systems of Integrated Sensors and Technologies
Program: ASSIST Summer Camp
Sample Applicant has applied to to the ASSIST Summer Camp program.
Student Information
| Name: | Sample Applicant |
| e-mail: | sample-applicant@example.com |
| Program Location: | NC State University |
| Week(s) Applied For: |
Parent/Guardian Information
| Full Name: | |
| Address: | |
| City: | |
| State: |
Zip: |
| Home Phone Number: | ( ) - |
| Other Phone Number: | ( ) - |
| email: | |
| Maximum Camp Sessions: |
I am a parent or legal guardian of Sample Applicant and I grant them permission to participate in the ASSIST Summer Camp program if selected.
If selected Sample will be available for the week(s) of ASSIST Summer Camp that they applied for.
Yes No
If no, please explain when they will be unavaliable.
If selected Sample will have transportation to and from ASSIST Summer Camp daily for the duration of the program.
If selected I agree to pay the camp fee prior to the beginning of the camp session. I understand that this fee will cover all materials and supplies for the camp as well as lunch.