PRECOLLEGE PROGRAMS LIFT

Transcription

1 PRECOLLEGE PROGRAMS SUMMER 2014 PROGRAM APPLICATION RETURN TO: Pre-College Programs- Program 0105B Cole Field House College Park, MD Fax: Phone: Students may apply for the program by completing and submitting this application to the above address or fax number. Please submit application by April 11, 2014 for Reduced Rate. Admission is on a first-come, first-served basis. Please check the programs you wish to apply to below, and specify whether you will be a Residential or Day Student Residential Students live on campus each week they are enrolled in the program, returning home on weekends. Day Students report to campus each morning at 8:30am and remain on campus until 5:00pm. Program Sessions Selection Resident Commuter Dates (Please check box next to desired dates) Make it Work: Innovation through STEM June Laissez Faire: Entrepreneurship in the 21 st Century July 7-11 Extra! Extra!: Current Topics in Journalism July Artistic Roots: Arts and Culture July Get Involved: Community Advocacy/Outreach July 28-Aug 1 College Bound: SAT and College Preparation Service Learning (Environmental OR Community Outreach) June 23-July 3 Environmental: June 23-July 11 July 7-18 July 21-Aug 1 Community Outreach: July 14-Aug 1 The Program strives to provide quality enrichment programs at affordable prices. Summer 2014 Rates: Purchase Options Reduced Price Regular Price (Please indicate Individual Sessions by Commuter Room/ Room/ Resident Commuter checking boxes for above choices) Board Board Resident 1-Week Academic Institutes $750 $245 $995 $950 $345 $1,295 Flex 2: Two academic weeks of your choice OR SAT $1,400 $490 $1,890 $1,600 $590 $2,190 Flex 3: Three weeks of your choice Academic only OR Academic and SAT OR $1,990 $735 $2,725 $2,190 $835 $3,025 Service Flex 4: Four weeks of your choice Academic OR mix of Academic, SAT, $2,650 $980 $3,630 $2,850 $1,080 $3,930 Service options Flex 5: Five weeks of your choice Academic OR mix of Academic, SAT, $3,350 $1,225 $4,575 $3,550 $1,325 $4,875 Service options Summer Program (6 weeks of your choice) $4,100 $1,470 $5,570 $4,300 $1,570 $5,870

2 STUDENT INFORMATION Name: First MI Last Sex: Mailing Address (while attending program): Telephone Number: Address: Permanent Address (if different from above): Please note: If you are not a U.S. Citizen or permanent resident, the permanent address listed above must be the home address in your home country Country: Citizenship: VISA Status: Telephone Number: Birth date: SCHOOL INFORMATION Name of School: City, State: Cumulative GPA: Current Grade: Expected Graduation Date: Anticipated Courses for the Fall 2014: English: Eng 7 Eng 8 Eng 9 Eng 10 Eng 11 Eng 12 Other: Math: Geometry Algebra I Algebra II Trig/Analysis Pre-Calculus Calculus PARENT/GUARDIAN INFORMATION Name: Address (if different from student): Work Phone: Cell Phone: Home Phone: Address: How did you hear about the program?:

3 PAYMENT INFORMATION A $200 NON-REFUNDABLE DEPOSIT* AND $50 APPLICATION FEE must accompany this application. Please make certified check or money order payable to UNIVERSITY OF MARYLAND. No cash or personal checks will be accepted. If you wish to use a credit card, please provide the information requested below: MASTERCARD VISA DISCOVER AMERICAN EXPRESS Customer Account Number: Name on Card: Expiration Date: Total Amount to be charged: Cardholder's Signature: *Deposit will be deducted from total cost of the program PLEASE BE SURE THAT YOU HAVE COMPLETED ALL SECTIONS OF THE APPLICATION. YOUR APPLICATION IS INCOMPLETE UNTIL WE HAVE RECEIVED: A 300-word typed essay answering the question: "How will the Program help you improve academically and personally in order to achieve your future goals?" An official copy of high school transcript (and most recent grades, if not yet recorded on transcript). $200 Non refundable Deposit. $50 Application Fee Signed Payment Policies Form I certify that the information on this application is complete and correct. If it is not, I understand that cancellation of admission and registration may result. I agree to abide by the rules, policies and regulations of the University of Maryland and the program if selected to participate. Signature of Applicant: Signature of Parent/Guardian: Date: Date:

4 PRE-COLLEGE PROGRAMS STUDENT ESSAY FORM SUMMER 2014 RETURN TO: Pre-College Programs- Program 0105 Cole Field House College Park, MD Fax: Phone: To the Applicant: Part of our commitment is to ensure that your individual needs are met during your experience with. Your response should be at least 300 words typed. Please use a separate sheet of paper and attach this form to your final essay. Name: First MI Last ESSAY QUESTION: Write about your academic challenges and experiences. How will the Summer Academy help you improve academically and personally in order to achieve your future goals? Please be aware that all students will be required to complete an interview with the Program Staff prior to being accepted into the program.

5 0105 Cole Field House College Park, Maryland TEL FAX PRE- COLLEGE PROGRAMS IN UNDERGRADUATE STUDIES Upward Bound Upward Bound Math and Science Summer Program Payment Policies Final program fees for the Summer Program will be due one month prior to the program start date. A non- refundable deposit of $200 and application fee of $50 will be due upon submitting an application for the program. The $200 deposit will be subtracted from the overall cost of the program. All refund requests must be made at least 30 days prior to the program start date. Any refund requests made after this date will not be granted. No exceptions. Additionally, any withdrawal from the program after April 30, 2014 will result in a fee equal to room and/or board fees charged to the Program by University of Maryland Conference Services, regardless of the program start date. The Summer Program offers an optional payment plan as listed below. The payment plan allows fees to be split into monthly payments based on the total cost of the program and the program start date. Fees will be due on Fridays, with each monthly payment increasing by 25%, i.e., four installments equal to 25% of the total program cost. The 2014 Payment date calendar is listed below. Summer Program Start Date 1 st Payment Due Date (25% of Total 2 nd Payment (50% of Total 3 rd Payment (75% of Total Final Payment (Balance Paid in Full) June 22 or 23, 2014 February 21, 2014 March 21, 2014* April 25, 2014 May 23, 2014 June 29 or 30, 2014 February 28, 2014 March 28, 2014 May 2, 2014 May 31, 2012 July 6 or 7, 2014 March 7, 2013 April 4, 2014 May 9, 2014 June 6, 2014 July 13 or 14, 2014 March 14, 2014 April 11, 2014 May 16, 2014 June 13, 2014 July 20 or 21, 2014 March 21, 2014* April 18, 2014 May 30, 2014 June 20, 2014 July 27 or 28, 2014 March 28, 2014 April 25, 2014* May 23, 2014 June 27, 2014 *University of Maryland Offices will be closed for Spring Break during this time. All non- electronic payments will be accepted on Monday, March 23 rd. Thank you for your participation in the Summer Program. If you have any questions regarding these policies and procedures, please contact the office or I verify that I have received this document and agree to the policies and procedures set forth by the Summer Program. Parent Name Date