Please select the program(s) for which you are applying.
Summer Preparation for Reaching Excellence Program (PREP - grades 6 - 8)
College Admissions Workshop (CAW- grades 9-12)
High School College Tour (grades 10-12)
Princeton Model Congress (PMC- grades 9-12)
Reading with the Deltas (grades 5-7)

Students Name
First: Last: (M. I.):
Sex: Male Female

Parent/Guardian
Mr. Mr. & Mrs. Mrs. Dr. Ms. First: Last: (M. I.):
Address:
      City: State: Zip code: -
  E-Mail: 

School: Grade: 1 2 3 4 5 6 7 8 9 10 11 12
Student's Reading Level: 1 2 3 4 5 6 7 8 9 10 11 12
Has the Student Repeated a grade? Yes No     If Yes, which grade? 1 2 3 4 5 6 7 8 9 10 11 12
Is the student receiving any form of supplemental instruction in school? Yes No
If so, Please Explain

Please select one:
Gifted & Talented
Basic Skills
Resource Room
Special Education Class
Other
None

Special Concerns:

Please check off all programs this student participated in last year or last summer.