The Summer Video Institute (June 21 - 25, 2021)

$100 deposit and $25 application fee are included in the $1,115 $50 deposit and $25 application fee are included in the $675

College Credits (For students with a high school graduation date of 2023 or prior)
Yes

Amount

First Name

Last Name

Gender Female
Male

Date of Birth

/ /

Street Address

City

State

Zip Code

Home Phone

Mobile Phone

Your current school's name

What grade will you be in Fall 2023?

Parent/Guardian names

Parent/Guardian's Work Phone

Relationship to Student