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Student Registration
General Information
First Name:   Last Name:  
Email:
Please provide an email address that will be checked regularly and will not be changed until after August (i.e. parent or guardians email address). All correspondence and acceptance materials will be emailed directly to this address.
Address 1:   Address 2:
City:   State:  
Zip:  
Home Phone: Student Cell:
Parent Information
Parent First Name: Parent Last Name:
Parent Phone: Parent Email:
Parent Email 2:    
Registration
Personal Information (for statistical purposes only)
Birth Date: Gender:  
Ethnicity:    
Disability (if any): Other:
Education Information
County:   High School:  
  Other:
Academic Year You Will Complete in June:
T-Shirt Size:    
Activities:
(Hold down the Ctrl key for to select multiple choices)
   
How did you hear about Business Week?
Other:
Camp Week Choices
Number incrementally in order of campus preference and indicate the program/pathway of interest
 
Western Washington University
Bellingham   06/24/2012 - 06/30/2012
Track Preference 1:
Gonzaga University
Spokane   07/08/2012 - 07/14/2012
Track Preference 1:
University of Alaska
Fairbanks   07/14/2012 - 07/21/2012
Track Preference 1:
Central Washington University
Ellensburg   07/22/2012 - 07/28/2012
Track Preference 1:
Pacific Lutheran University
Tacoma   08/05/2012 - 08/11/2012
Track Preference 1:
Pricing Information
Payment Tier:
(for information on our Tier Pricing click here.)
Payment Information
Payment Type:
Billing Information
Billing Address
Address 1:   Address 2:
City:   State:  
Zip:  
Comments
Additional comments / requests
 


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