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Download our Application form by clicking here.
Download our complete brochure.
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We make applying
easy! Just print out this page, fill it out, and mail it to our Summer
Camp Office. Or you may download the PDF
file of our form and use that to apply. You may apply up until the
start of the week you wish your child to attend (space permitting).
Mail this completed application
to:
Parent/Guardian’s Social Security # ________________________________ Child’s Name _____________________________________________________ Sex (circle one) M F Date of Birth ____________ Grade entering Fall 2002 _________________ Address___________________________________________________________ City, State, Zip____________________________________________________ E-mail_______________________________________________________ Home Phone #___________________________ Daytime/Work Phone # ____________________________ T-shirt Size (please
circle one)
Camp Length (please circle number of weeks):
Camp Dates Selected:
________________ |
Transportation: Transportation services will only be provided if a minimum number of passengers per route request service.
Bus (designated
drop-off) — $130/week
Check
here if you will be choosing the late pickup option. Please note that there
is a $50 per week charge for this option.
Check
here if you are registering more than one child. Please copy this form and
fill out for each child attending camp.
Check
here if you are a Stony Brook University faculty or staff member.
| Tuition $__________ |
|
| Application Fee (nonrefundable) | $25.00 |
| Late pick-up option, # weeks ____ x $50 | $__________ |
| Additional T-shirts: # ______ x $8 | $__________ |
| Transportation:
Bus # weeks _______ x $130 |
$__________ |
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Total: |
$__________ |
| Less deposit/registration
fee Deposits are not refundable after June 1, 2002 (Except if transportation service cannot be provided.) |
$ 175.00 |
|
Balance due prior to 6/01/02 |
$__________ |
FORM OF PAYMENT
payable to: SBF Account # 960000
Check/Money Order
Credit Card Information
Account # ____________________________________
AMEX
Discover
MasterCard
Visa Exp.
Date _______________
Cardholder Name ____________________________________
Signature ____________________________________
Please return form to the Summer Camp at Stony Brook