Field School in Industrial and Historical Archaeology
Michigan Technological University
Application Form
Name
Address
City
State
Zip
Daytime Phone (
Evening Phone (
Email
You are enrolling for: O Graduate Credit O Undergraduate Credit
Describe your Class standing and reason for enrolling in this course:
Person(s) to be notified in case of emergency:
(include relationship to student)
)
)
O Volunteer
Insurance provider:
Policy #:
Phone:
Phone:
Please identify any food or environmental allergies, physical or health related concerns about which you
wish to make us aware:
Michigan Technological University’s Industrial Archaeology faculty are committed to equal
opportunity in archaeology. Given the nature of fieldwork, students with disabilities or special needs
should contact the instructor to discuss accommodations as part of the registration process.
The field school is filled on a first come, first serve basis. To ensure a spot on the research team,
please complete this form and return it before March 1 to:
IA Field School
Prof. LouAnn Wurst, Department of Social Sciences, 209 Academic Office bldg.
Michigan Technological University Houghton, MI 49931
Telephone (906) 487-3188
Email: l a w u r s t @ M T U . e d u
You may send this information by email, instead of hard copy.