BSHS 2017 APPLICATION
Please answer the following questions completely in order to be considered for Brown Summer High School 2017.
BSHS will take place on Brown University's campus from Wednesday July 5th to Wednesday, July 26th, 2017.
For more information, check out our website at brown.edu/go/summerhighschool.
You can also call us at 401-863-1677 to leave a voicemail message, or email bshs@brown.edu.
Last Name
Your answer
First Name
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Phone
e.g. 123-456-7890
Your answer
Student's Email
Your answer
Student's Current School
Your answer
Student's Grade, Fall 2017
Please choose your grade from the dropdown list below.
Student's School, Fall 2017
Your answer
Date of Birth
e.g. 8/30/94
Your answer
PARENT / GUARDIAN INFORMATION
Parent / Guardian Name
(First Last)
Your answer
Parent / Guardian Email
Your answer
Daytime Phone
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Brown University. Report Abuse - Terms of Service - Additional Terms