SCIENCE ISLAND EXTREME
Camper Application & Personal Information

Complete this form and click submit.

* Required Information

Camper Information
Legal First Name:*

Legal Last Name:*

Middle Initial:

Preferred Name, if not Legal First Name:

Gender:*

Address:*

City:*

State:*

Zip:*

Country:*

Home Phone Number:
Format: 555-111-9876

Camper's Mobile Phone Number:
Format: 555-111-9876

Camper's Email Address:*

Date of Birth:*
Format: 04/23/2014

T-Shirt Size:*


Mother or Guardian Information
Please provide information where different from student.


First Name:*

Last Name:*

Address:

City:

State:

Zip:

Country:

Home Phone Number:
Format: 555-111-9876

Guardian's Mobile Phone Number:
Format: 555-111-9876

Guardian's Email Address:


Father or Guardian Information
Please provide information where different from student.


First Name:*

Last Name:*

Address:

City:

State:

Zip:

Country:

Home Phone Number:
Format: 555-111-9876

Guardian's Mobile Phone Number:
Format: 555-111-9876

Guardian's Email Address:


How Did You Hear About Us
Please tell us how you heard about Science Island Extreme @ Saint Joseph's College:*

Name of the person who referred you to us:


High School Information
In addition to your high school transcript, please submit a signed letter of recommendation on school letterhead (no longer than one page, please) from your guidance counselor or a teacher who can attest to your intellectual capabilities, maturity, and ability to cooperate with others.

Also, please submit a short essay (no longer than 1 page, please) answering the following:
  • 1. Why would you like to attend Saint Joseph's College summer camp?
  • 2. What character traits will you bring to camp which will benefit you and your fellow campers?
  • 3. What do you hope to learn from your summer camp experience?

High School Name:*

Address:*

City:*

State:*

Zip:*

Country:*

Cumulative High School GPA:*


Payment Information
Tuition for Camps:
  • SJC Summer Experience taking 1 course $1,836
  • SJC Summer Experience taking 2 courses $2,772
  • Gulf of Maine Environment by Sea Kayak $2,395
  • Science Island Extreme: Science of Survival $1,895

  • $500 deposit per camp is due with application form - $300 per camp refundable until May 1, 2014
    Balance due prior to July 1, 2014


    This is a secure site so you may pay for your fees at this time using MasterCard, Visa, American Express and Discover cards.

    Method of payment:
    If paying by check or money order, mail your payment to:
    Graduate & Professional Studies
    Saint Joseph's College of Maine
    Attn: Student Accounts Coordinator
    278 Whites Bridge Road
    Standish, ME 04084-5263


    Health
    Has the camper previously seen, or is presently seeking medical assistance for any physical or mental health problem(s)?*

    If yes, please explain:


    Agreement
    Tuition: We require a registration deposit of $500 per camp ($300 per camp of which is refundable until May 1, 2014) to be credited toward the tuition of summer camp. We understand that the balance of the tuition is due by July 1, 2014.

    Essential Functions: The nature of Saint Joseph's College Summer Camp requires that campers are able to meet their own personal hygiene needs, feel comfortable in and around the lake and the ocean, be responsible for their own belongings, and be able to work cooperatively in a group setting.

    General Expectations & Standards: Campers are expected to be respectful, caring, honest and collaborative. General expectations will be reviewed on the first evening with all campers but there are some activities which are absolutely prohibited and may result in immediate dismissal, without tuition refund, because they relate to the health and safety of the community. These include: the possession, use or sale of: alcohol, tobacco products, illegal drugs and firearms.

    Withdrawals and Dismissals: For any camper who arrives late or withdraws after July 1st tuition is still due in full. Saint Joseph's College Summer Camp Staff reserve the right to dismiss any camper who does not comply with camp standards. (see above paragraph)

    Health: We understand that all summer campers are required to submit the Health History form by July 1, 2014. This form will be signed by a parent or guardian and will include a copy of immunizations, allergies, current medications and health concerns.

     
    Guardian Agreement:*
    Type AGREE here if you agree with all terms and conditions listed above.

    Guardian Type Your Full Name:*

    Agreement Date:*
    Format: 04/23/2014


    Camper Agreement:*
    Type AGREE here if you agree with all terms and conditions listed above.

    Camper Type Your Full Name:*

    Agreement Date:*
    Format: 04/23/2014




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