Summer Literacy Institute Registration Request Form
July 10-13, 2017 at the Hamline University Saint Paul Campus.

This form is only a request for registration. Registration is not official until you have received confirmation from the Office of Registration and Records. Please allow at least three (3) business days for a reply.

Email address *
Hamline ID (if known)
Your answer
First Name *
Your answer
Last Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Phone Number *
Your answer
Date of Birth (month/day/year) *
Your answer
Gender
Please select ONE of the following options: *
* Once the conference has begun, students will NOT be allowed to change course options between credit and non-credit bearing.

** A $50 Early Bird Discount will be given to registrations RECEIVED on or before June 19, 2017 making the rates $495 for the conference only option, and $645 for credit bearing option.

Payment Options *
Electronic payment options:
1. ACH E-check payment for no fee - you will need your bank routing and account numbers.
2. Credit card payments via MasterCard, Visa, Discover, or American Express with a 2.75% convenience fee.

Please see hamline.edu/billing for more information.

Submit
Never submit passwords through Google Forms.
This form was created inside of Hamline University. Report Abuse - Terms of Service - Additional Terms