Summer Physics [SuPhy) Program Application (last, first, middle) Student’s Name Street Address, Apt. No. City State Zip Date of Birth Male Female Parent or Guardian’s Name(s)   Home Telephone Cell Phone Parent/Guardian Email Student Email Current School 2017-2018 Grade in 2017-2018 be a new student at Horace Mann in the Fall of 2018? Yes No   For Horace Mann Students On y: Has this student received financial aid from the Horace Mann School in the 2017-2018 school year, or been approved for financial aid for the 2018-2019 year? Yes No   For complete information on Financial Aid, please click on the link provided under "Registration & Costs" on the Summer School page. I n case of an emergency: Name Doctor’s Doctor’s Telephone Emergency contact other than parent: Name Address Telephone Summer Physics (Dates Cost Thursday June 18 - Friday July 27, 2018) of Course: $4410 Parent and Advisor Sig n-off [for HM students only) Any Horace Mann student applying to take a course for credit must have the approval of his or her parent/guardian and his or her advisor. Please make sure that this application form is signed by both, indicating that you have had a discussion with your parent/guardian and your advisor and have received approval to apply for the course. Any applications received without these signatures will be returned to the student and his or her application will be considered incomplete. Parent/Guardian Advisor l h
Summer Physics [SuPhy) Program Application Student’s Name (last, first, middle) Street Address, Apt. No. City State Zip Date of Birth  Male  Female Parent or Guardian’s Name(s) Home Telephone Cell Phone Parent/Guardian Email Student Email Current School 2017-2018 Grade in 2017-2018 be a new student at Horace Mann in the Fall of 2018?  Yes  No For Horace Mann Students On l y: Has this student received financial aid from the Horace Mann School in the 2017-2018 school year, or been approved for financial aid for the 2018-2019 year?  Yes  No For complete information on Financial Aid, please click on the link provided under "Registration & Costs" on the Summer School page. I n case of an emergency: Doctor’s Name Doctor’s Telephone Emergency contact other than parent: Name Address Telephone Summer Physics (Dates Thursday June 18 - Friday July 27, 2018) Cost of Course: $4410 Parent and Advisor Sig n-off [for HM students only) Any Horace Mann student applying to take a course for credit must have the approval of his or her parent/guardian and his or her advisor. Please make sure that this application form is signed by both, indicating that you have had a discussion with your parent/guardian and your advisor and have received approval to apply for the course. Any applications received without these signatures will be returned to the student and his or her application will be considered incomplete. Parent/Guardian Advisor h
HM_Summer_School_SuPhy_2018.docx