Engineering Camp 2021
Please complete this webform to apply for Engineering Camp at Bucknell University
June 27 - July 1, 2021.
* Required
Email address
*
Your email
Camper Last Name
*
Your answer
Camper First Name
*
Your answer
Camper Email Address
*
Your answer
Camper Mobile Phone Number
*
Your answer
Home Address
*
# Street
Your answer
City, State, Zip Code
*
Your answer
Expected Year of High School Graduation
*
2025 (rising 8th grader)
2024 (rising 9th grader)
2023 (rising 10th grader)
2022 (rising 11th grader)
2021 (rising 12th grader)
Date of Birth
*
MM/DD/YYYY
Your answer
Gender
*
Female
Male
T-Shirt Size (adult sizes)
*
Small
Medium
Large
X-Large
XX-Large
Parent/Guardian 1 Name
*
First and Last Name of Primary Contact #1
Your answer
Parent/Guardian 1 Phone Number
*
Needed for emergency contact.
Your answer
Contact email address
*
Primary email address of the person who would like to be contacted about Camp (parent, guardian).
Your answer
Parent/Guardian 2 Name
First and Last Name of Primary Contact #2
Your answer
Parent/Guardian 2 Phone Number
Your answer
Name of teacher providing recommendation
*
Your answer
Email address of teacher providing recommendation
Your answer
Name of guidance counselor providing recommendation
*
Your answer
Email address of guidance counselor providing recommendation
Your answer
Name of your current middle/high school
*
Your answer
Address of your current middle/high school
Your answer
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