Application - Institute for Law, Justice & Society

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Law Camp '12 Application Form

This is the application form for the Institute for Law, Justice & Society's Law Camp 2012. Please fill out all required fields marked with an asterisk (*).

Law Camp will be held the week of June 25. The price is $400 if the application is received by May 15. The price is $500 if registered after May 15. No applications will be accepted after June 1.

The cost includes room, board, and all course materials. Space is limited to 30 participants, so apply early.

Basic Information
* First Name
* Last Name
* Name for Nametag
Gender	Male Female
* Your High School
Grade level in Fall '12	9 10 11 12
* Address 1
Address 2
* City
* State
* Zip
* Phone (Home or Cell)
* E-mail Address
Emergency Contact Information Please provide at least one emergency contact. All information is required.
* Parent/Legal Guardian 1 First Name
* Parent/Legal Guardian 1 Last Name
* Parent/Legal Guardian 1 Address
Parent/Legal Guardian 1 Address (cont.)
* Parent/Legal Guardian 1 City
* Parent/Legal Guardian 1 State
* Parent/Legal Guardian 1 Zip
* Parent/Legal Guardian 1 Phone
Parent/Legal Guardian 1 Phone
Parent/Legal Guardian 1 Phone
* Parent/Legal Guardian 1 E-mail Address

Parent/Legal Guardian 2 First Name
Parent/Legal Guardian 2 Last Name
Parent/Legal Guardian 2 Address
Parent/Legal Guardian 2 Address (cont.)
Parent/Legal Guardian 2 City
Parent/Legal Guardian 2 State
Parent/Legal Guardian 2 Zip
Parent/Legal Guardian Phone
Parent/Legal Guardian 2 E-mail Address
Additional Information
Special Accommodations (Dietary, Housing, Learning)
High School Counselor's Name
* Type both words below, separated by a space. Can't read the words below? Try different words or an audio captcha.

Basic Information

Emergency Contact Information

Additional Information