Oxford Enrollment Information Form

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Legal First Name *

Preferred First Name or Nickname

Middle Initial or Name

Last Name *

Middlebury College ID Number

8-digit ID found in your letter, begins with zero

Age

Gender

In what state do you reside?

What is your preferred or current e-mail address?

Do you wish a room reserved for you on the Oxford campus? *

Yes

If yes, please indicate your preferred location:

Lincoln College (private bedroom, en suite bathroom)

Bear Lane (private bedroom, shared bathroom)

Clear selection

Will you require family housing?

Family housing includes partners and/or children; families with children get first priority.

Yes

Clear selection

If yes, for family housing, how many bedrooms will be needed?

Please list the name and ages of children as well as spouse or partner.

For students without children, will your partner or spouse be staying with you in your room for the entire session?

There will be an additional cost for a non-student spouse or partner staying for entire session. Visitors for less than the whole session must make alternative housing arrangements.

Yes

Clear selection

If yes, please list name of spouse or partner who will be accompanying you for the summer.

Please describe any condition that requires special housing accommodations (documentation may be required).

Any comments on housing or special requests?

What method will you be using to pay your program deposit?

The $400 deposit is due by the date in your letter or 2 weeks after financial aid notification.

check or money order made out to Middlebury College and mailed to the Bread Loaf office

credit card or e-check via the on-line link

deferring payment waiting for financial aid decision

deferring payment waiting for special fellowship decisions

Clear selection

Are you applying for financial aid?

Yes

Clear selection

Are you applying for a special fellowship? If so, which one?

What is your occupation?

Who is your employer (school or company name plus address)?

If a teacher, please indicate if school is private or public; Title 1 or charter.

Submit

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