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It had long since come to my attention that people of accomplishment rarely sat back and let things happen to them. They went out and happened to things.

Leonardo da Vinci

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Summer Academy

Summer Academy Online Application Form PDF Print E-mail

Course Choices
Please choose your preferred course First Choice:
Course:
Code:
If first choice is not available Second Choice:
Course:
Code:
Previous Knowledge of Italian: No previous knowledge of Italian:

Student Information
Family Name: Given Name(s):
Permanent Address:
(include postal/zip)
Email Address: Home Telephone:
Date of Birth:
Day: Month: Year:

Mother's Information
Mother's Name: (Mrs/Ms/Dr)
Home Address
(include postal/zip):
Email Address:
Home Telephone: Business Telephone:

Father's Information (if different from above)
Father's Name: (Mr/Dr)
Home Address:
(if different from above)
Email Address:
Home Telephone: Business Telephone:

Guardian's Information (if necessary)
Name of Legal Guardian (if applicable):
(Mr/Mrs/Ms/Dr)
Guardian's Address:
(include postal/zip)
Email Address:
Home Telephone:
Business Telephone:

Summer Contact Information
Name of Summer Contact
Home Telephone:
Business Telephone:
Email Address:

Emergency Contact Information
In case of emergency, please contact:
Home Telephone:
Business Telephone:

Payment, Reports & Schooling
Invoices for fees and other charges should be sent to: Mother    Father    Guardian
Reports & other information should be sent to: Mother    Father    Guardian
Name & Address of
Present School:
School Phone Number:
School Fax Number:
Guidance Counselor:

Student Preferences Questionnaire
  1. Please write a 250 word essay explaining why you wish to attend our summer program. (to be completed by applicant)

  2. Briefly describe your ideal roommate or provide us with the name of an attending student you wish to room with


  3. Do you have any physical conditions that we should be aware of? (e.g. Food allergies, epilepsy, diabetes)
    Do you have any restrictions with regard to physical activity?

Insurance
I wish to purchase:
Cancellation Insurance add $120.00
Medical Insurance add $60.00 (available to Canadian residents only)

Please provide us with an email address where we can contact you:
 

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