2016 COLORADO COLLEGE SUMMER SESSION
PRE-COLLEGE COURSE APPLICATION
Admission to the Colorado College Summer Session Pre-College program requires applicants to complete this form. Form may be filled out and
submitted to [email protected] Alternatively, mail this completed and signed form along with all the other required documents to:
Colorado College, Pre-college program, Summer Session Office, 14 E. Cache La Poudre, Colorado Springs, CO, 80903. See checklist on page two for
a complete list of all items to include with your application. Only students who will be seniors during the 2016 fall semester may apply for
scholarship and merit awards using the form found on the Summer Session website.
Please type or print. To fill out online, click in gray boxes and type. Fields will expand as needed.
APPLICANT’S NAME and PERSONAL DATA:
This fall, I will be a high school
Junior
Senior
Other – please explain:
Last (family name):
First:
Middle:
Date of Birth (required for admission and transcripts):
Place of Birth (required for admission and transcripts):
Ethnicity: (Check one or more that describe your background.)
American Indian or Alaska Native (including all Original People of the Americas)
Asian (including Indian subcontinent and Philippines)
Black or African American (including Africa and Caribbean)
Gender:
Hispanic or Latino (including Spain)
Native Hawaiian or Other Pacific Islander (Original Peoples)
White (including Middle Eastern)
APPLICANT’S CURRENT MAILING ADDRESS:
Street and number:
City:
State/Province:
Zip/Postal Code:
Country (if other than US):
Expiration for this address:
Cell Phone:
Cell valid through summer?
Email Address:
Expiration for this address:
Yes
APPLICANT’S PERMANENT MAILING ADDRESS (if different from above):
Street and number:
City:
State/Province:
Zip/Postal Code:
Please indicate the best way to reach you:
E-mail
Phone
Current Mailing Address
Country (if other than US):
Permanent Mailing Address
PARENT CONTACT INFORMATION:
Parent 1 - Name:
Parent 2 - Name:
Address -(if different from above) Street and number:
City:
Primary phone:
State:
Zip:
Secondary phone:
Address -(if different from above): Street and number:
City:
Primary phone:
Email:
State:
Zip:
Secondary phone:
Email:
EMERGENCY CONTACT: (PLEASE PROVIDE CONTACT INFORMATION FOR SOMEONE OTHER THAN A PARENT)
Name:
Relationship to student:
Primary Phone:
Street Address:
City:
Secondary Phone:
State/Province:
Zip/Postal Code:
Country (if other than US):
BILLING PARTY INFORMATION:
Last Name:
First Name
Middle name:
Street Address:
City:
State/Province:
Zip/Postal Code:
Country (if other than US):
SCHOOL INFORMATION:
Name of Current School:
Are you in good standing at your current school?
If No, please attach a letter with explanation.
Expected Date of Graduation:
Yes
No
GPA:
Who drove the decision to apply for Colorado College Summer Session?
I did
my parents
both
Other:
Rank
No
Please select which pre-college program you are applying for:
Regular Block A and/or B courses (Option 1)
Pre-College only Block course (Option 2)
OPTION 1: REGULAR BLOCK COURSES: PLEASE LIST THE COURSES YOU WISH TO TAKE THIS SUMMER: Students can enroll in only one course per
block.
Course
GRADE
CRN #
COURSE #
COURSE TITLE
INSTRUCTOR
UNITS
TRACK*
choices
Block A
Block A
2nd Choice
AND
OR
Block B
Block B
2nd Choice
OPTION 2: PRE-COLLEGE PROGRAM BLOCK COURSE(S):
PLEASE SELECT ONE OF THE FOUR MAIN COURSES, AND THE OPTIONAL COLLIGIEATE COMMUNICAITONS COURSE, IF DESIRED.
Course
choices
INSTRUCTOR
CC UNITS
(SH = semester hours)
Cross Genre Writing Workshop
Goodwin and Hayward
.75 (3 SH)
EV 100
From Grassland to Glacier
Mike Taber
.75 (3 SH)
30096
.PS 102
Freedom and Empires: The Drama of
Ancient Politics
John Grace
.75 (3 SH)
30095
SO 102
Communities and Networks
Kathy Giuffre
.75 (3 SH)
Julian Plaza
.25 (1 SH)
CRN #
COURSE #
30093
EN 104
30094
COURSE TITLE
GRADE
TRACK*
The following course is MANDATORY FOR INTERNATIONAL STUDENTS.
It is OPTIONAL FOR DOMESTIC STUDENTS.
30097
GS 103
Communications for Collegiate Success
*Grade Track: P=Pass/Fail (S, CR, NC) G = Grade (A, A-, B+, B, B-, C+, C, C-, D, NC) (Grade track changes may be made only during the first four days of class)
Applications will be reviewed on a rolling basis. You will receive notification of acceptance within two weeks of receipt of completed application. Course schedules and
additional information will be sent separately.
Course deposits ensure a place in a desired course and go toward tuition. Tuition for summer 2016 is $4000 per unit.
$500 for each 1 or 2 unit course .................................................................................................................................................. $
+ Application fee ............................................................................................................................................................................... $50.00
= total charge .......... $
Financial Obligation:
I accept responsibility for financial charges (e.g. tuition, course fees and collection costs if delinquent) associated with pre-registering for a Colorado College summer
session course(s) and understand and agree with the refund policy and withdrawal procedures. (A detailed explanation of course withdrawal and refunds is available
at www.ColoradoCollege.edu/SummerSession).
I have read and agree to potential financial charges as indicated above, per my typed signature as financially responsible party.
Signature of Financially Responsible Party:
(must be parent or legal guardian if applicant is under 18 years of age)
CHECK
CREDIT CARD
Please send two separate checks, payable to Colorado College,
One for application fee and one for course deposit(s).
Call 719-389-6098 with credit card information.
Applicant’s admission checklist:
Application
Transcript(s)
Teacher Report
Counselor Report
Housing application
How did you first find out about Colorado College Summer Session?
Colorado College website
Direct email from CC
Google Ad
Teacher/faculty member
Facebook Ad
School counselor
C.C. alumnus/alumna
Parent
Campus Tour
Other family member
For office use only:
Registrar:
Summer Student Code:
High School
Check 1: Application Fee - $50
Check 2: Deposit fee of $500 per unit
SS:
Date of email to student: ___________________
Date of App/letter to registrar: _____________
Date of App to housing: _____________________
High school fair
TheEducationalRegister.com
USummer.com
Printed ad, where?
Other:
Download

Colorado College Summer Session 2006