GERI Summer Camps - Gifted Education Resource Institute - Purdue ...

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GERI Summer Camps application Side 2 Course Preferences Please follow these instructions carefully: 1. Check the box next to each Summer Camp session you plan to attend. 2. Mark your 1st, 2nd, 3rd choices in the blank next to the class name (1 = first choice, 2 = second choice, etc.). If you plan to attend multiple sessions (e.g., Star I and Star II), list a first, second, and third choice for each session you plan to attend. Travel information: ❑ I will need to be picked up at the Indianapolis International Airport. An additional fee of $60 is due when the application and $100 deposit are submitted. Indicated below. ❑ I will make my own transportation arrangements. Before sending: Have you included the following required items (see page 10): 1. Completed application 2. Student essay or alternate media 3. Two of the academic eligibility documents 4. $100 deposit 5. $60 transportation fee, if applicable. Return to: GERI Summer Camps Purdue University Beering Hall, Room 4133 100 North University Street West Lafayette, IN 47907-2098 Fax: (765) 496-2706 COMET–SN8426 (completed grade 5 or 6) ❑ Comet I, July 3-9 Commuter ($595) ❑ Comet I, July 3-9 Resident ($950) _________MEDICAL SCHOOL MADNESS _________LEGO ROBOTICS _________POP ART _________THE COMMON SOLDIER IN THE CIVIL WAR _________EXPERIMENTAL CHEMISTRY _________FUN WITH MATH STAR–SN8428 (completed grade 7 or 8) ❑ Star, July 3-16 ($1,750) Morning _________INTRODUCTION TO GENETICS _________ARCHITECTURE AND DESIGN _________MIXED-MEDIA AND FOUND-OBJECT ART _________CAUSE FOR CONFLICT _________VIDEO JOURNALISM AND PHOTOJOURNALISM _________ENLIGHTENED ELECTRONICS Payment Method Payment in full is due one month before the program starts. ❑ Enclosed is a check made payable to Purdue University. Please charge to my: ❑ VISA ❑ MasterCard ❑ Discover ❑ American Express ❑ Comet II, July 10-16 Commuter ($595) ❑ Comet II, July 10–16 Resident ($950) _________PSI – PLANT SCIENCE INVESTIGATION _________ROCKET SCIENCE _________ _________ _________SCULPTURE THROUGH THE AGES _________VIETNAM AT HOME AND ABROAD _________COMPUTER MODELING AND ANIMATION Afternoon PULSAR–SN8427 (completed grade 9, 10, 11, or 12) ❑ Pulsar, July 3-16 ($1,750) Morning Afternoon _________ORGANIC CHEMISTRY _________ALIENS: FACT OR FANTASY? _________ _________REACTING TO THE PAST _________LONG IMPROV _________THE PSYCHOLOGY OF PEOPLE _________MOVIE MAKING _________FINANCIAL MATH Application Fees Tuition $ _________________________ _________RESEARCH CHEMISTRY _________ALL ABOUT ENGINEERING _________AEROSPACE ENGINEERING _________SHORT IMPROV _________POLITICS AND PERSUASION _________GAME DEVELOPMENT _________THE POLITICS OF YOUTH REBELLION IN AMERICAN CULTURE _________CHEMICAL ENGINEERING _________THE PHYSICS OF SPACE TRAVEL _________MURDERS THAT CHANGED HISTORY _________ _________INTERVIEWING AND PERSONAL DEVELOPMENT _________SOFTWARE ENGINEERING _________MATHEMATICS OF RISK Transportation $ _________________________ An additional fee of $60 is due when application and $100 deposit are submitted. Contribution $ _________________________ Total $ _________________________ Deposit $ _________________________ Balance Due $ _________________________ Due one month before the program starts. Credit Card Number ____________________________________________________Expiration Date_____________ Printed Name_________________________________________________________________________________ 12 Signature ___________________________________________________________________________________
Financial Aid application Child’s Name _______________________________________________________________________ Parent/Guardian Name _______________________________________________________________ Home Phone (_____) _______________________ Work Phone (_____ ) ______________________ All amounts should be the total for the 2009 calendar year. 1. Adjusted gross income __________________________ 2. Taxable income __________________________ 3. Total Social Security benefits for 2009 __________________________ 4. Total AFDC and/or ADC for 2009 __________________________ 5. Child support received for all children __________________________ 6. Number of household members a. Yourself ___ b. Spouse ___ c. Dependents ___ Total of a, b, and c __________________________ I certify that the information supplied above is accurate. Parent/Legal Guardian Signature ________________________________________________________ Please return this completed form along with your application and eligibility documentation to: GERI Summer Camps Purdue University Beering Hall, Room 4133 100 North University Street West Lafayette, IN 47907-2098 Fax: (765) 496-2706
Page 2 and 3: About the Gifted Education Resource
Page 4 and 5: Please check our Web site for updat
Page 10 and 11: “The counselors were great and I
Page 12 and 13: Admission requirements GERI Summer
Page 16: GERI SUMMER CAMPS Gifted Education

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