2018 Student Summer Institute - June 25-29, 2018

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Ticket type

PWI Student Summer Institute PLUS BOOKS ($380.00) PWI Student Summer Institute ONLY ($350.00) MONDAY SSI ($80.00) TUESDAY SSI ($80.00) WEDNESDAY SSI ($80.00) THURSDAY SSI ($80.00)

* Email

* First name

* Last name

* School

Enter the name of the school you will attend in Fall 2018 or write "homeschool" if applicable.

Grade

Please enter the grade you will enter in Fall 2018.

* Parent/Guardian Name

Please enter the name of your primary parent/guardian.

* Contact Phone

Please enter a phone number where your parent/guardian can be reached.

* Emergency Contact

Enter the name of a person who can be reached in case of emergency (different than your primary parent/guardian).

* Emergency Contact Phone Number

Phone number where the emergency contact can be reached.

Photo/Video Release

I DO give permission for the young writer's likeness to be used in photographs and/or videos in order to advertise for Project Write, Inc.I DO NOT give permission for the young writer's likeness to be used in photographs and/or videos.

Please select an option.

Special Information

Please note here any food allergies or special instructions of which we need to be aware.

Tshirt Size

Adult S, M, L, or XL

Where Did You Hear About Our Program?

Have you attended one of our programs in the past?

If you are the child of an SU employee, please list your parent/guardian's name and SU job title and/or department.

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