EmailMeForm
UBMS 2024 Summer Enrichment Program Confirmation
Confirmation Form
WE WILL BE RESIDENTIAL AT LEAST PART OF THIS SUMMER.
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Name
*
First
Last
Gender
Male
Female
Prefer not to say
High School
*
Grade NEXT year (2024 - 2025)
*
Please select
9th
10th
11th
12th
Cell Phone
*
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Email
*
Summer Program Participation (6/23 - 8/2)
*
I will be participating in the UBMS Summer Program this year.
I will only be able to participate in some of the Summer Program.
I will not be participating in the Summer Program this year. (Reason)
T-shirt size
*
Please select
S
M
L
XL
XXL
XXXL
Do you have any potential conflicts or planned absences during the five weeks of the summer program? If so, please give dates and explanations below.
*
Yes
No
Date
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DD
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YYYY
Reason
Date
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DD
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YYYY
Reason
Date
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YYYY
Reason
If you have roommate preferences, list the person/people here.
1st Choice
2nd Choice
3rd Choice
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