Engineering Camp 2021
Please complete this webform to apply for Engineering Camp at Bucknell University
June 27 - July 1, 2021.
Email address *
Camper Last Name *
Camper First Name *
Camper Email Address *
Camper Mobile Phone Number *
Home Address *
# Street
City, State, Zip Code *
Expected Year of High School Graduation *
Date of Birth *
MM/DD/YYYY
Gender *
T-Shirt Size (adult sizes) *
Parent/Guardian 1 Name *
First and Last Name of Primary Contact #1
Parent/Guardian 1 Phone Number *
Needed for emergency contact.
Contact email address *
Primary email address of the person who would like to be contacted about Camp (parent, guardian).
Parent/Guardian 2 Name
First and Last Name of Primary Contact #2
Parent/Guardian 2 Phone Number
Name of teacher providing recommendation *
Email address of teacher providing recommendation
Name of guidance counselor providing recommendation *
Email address of guidance counselor providing recommendation
Name of your current middle/high school *
Address of your current middle/high school
Submit
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