*
indicates a required field
Student Information:
Full name:
*
Preferred name:
Home address:
*
Mailing address:
*
E-mail address:
Daytime telephone:
*
Student’s Cell Phone:
High school:
*
Grade you will be entering in the fall of 2008:
*
Please choose:
9th grade
10th grade
11th grade
12th grade
High school graduation date:
*
Please indicate your top four course choices. You will be enrolled in two of the four courses you select, depending on course availability. Only applicants who submit a $100 deposit will be considered for class placement.
Courses:
Becoming a Leader
Creative Writing
Exploring Pottery
Finding Hidden Meanings: Politics in Literature
Location, Location, Location: Learning Navigation Skills
Modern Dance
Painting
Photography
Psychology: The Human Mind
First choice:
Second choice:
Third choice:
Fourth choice:
Please indicate your top three choices. You will be enrolled in one.
Athletic Clinics/Outdoor Program:
Basketball
Environmental ethics
Golf
Lacrosse
Soccer
Swimming
Tennis
Volleyball
First choice:
Second choice:
Third choice:
How did you hear
about Hollinsummer?
*
Please choose:
Brochure
Family member
Friend
High school teacher
High school guidance counselor
Hollins admissions representative
Hollins alumna
Newspaper ad
Web site
Other
How to Pay Your $100 Deposit to Secure Your Place.
I will phone the Admissions Office (
800-456-9595
) with my credit card information.
I will mail my check made payable to ''Hollinsummer'' to:
Hollinsummer Program
Hollins University
P. O. Box 9707
Roanoke, VA 24020
Parent or Guardian Information:
Parent or
legal guardian:
*
Father's daytime
telephone:
*
Father's Cell Phone:
Father's e-mail
address:
Mother's daytime
telephone:
*
Mother's Cell Phone:
Mother's e-mail
address:
What are your reasons for wanting to attend the Hollinsummer program?
*