2010 Summer Academies Registration Form

The WVU Parkersburg Summer Academies are designed for high school students, grades 10-12.

STUDENT'S NAME:

HOME ADDRESS:   

CITY/STATE/ZIP      

HIGH SCHOOL        

BIRTH DATE           

PHONE NUMBER:  

EMAIL ADDRESS: 

Please check the academy(ies) for which you are registering:

Health Care Academy (June 14-18) Technology 101 (June 14-18)   Early Childhood Education (June 14-18) PSYC Night (MALES June  21-22) Crime Scenes (June 21-25)

Health Care Academy (June 21-25) Technology 101 (June 21-25)   Early Childhood Education (June 21-25) PSYC Nights (FEMALES June 23-24)

**$10.00 non-refundable deposit required for each academy with registration form. (Make checks payable to WVU Parkersburg)**

Registrations must be received by June 1, 2010
Forms may be submitted on line or mailed to:

West Virginia University at Parkersburg
Attention:  Summer Academies
300 Campus Drive
Parkersburg, WV  26104