Registration

Request Information

Name:
Address:
City/State/Zip:
Phone Number:
E-mail
High School:
Month/Year of High School Graduation:
Year I Will Enter College:
Proposed Field(s) of Study:
Activities and Interests:
I am interested in the Summer Academy in Mathematics and Science.	Yes No
I am interested in information about Elmhurst’s undergraduate programs.	Yes No
I am interested in taking the Academy for college credit.	Yes No
Ethnic/Racial Group (optional):	African American Asian American Caucasian American International (non U.S. citizen) Latin American Multiracial Native American Pacific Islander Other