Summer Institute on College Admissions Registration Form

June 17–22, 2012, Cambridge, Massachusetts
Sponsored by Harvard University and The College Board

You may use this form to submit your online registration to us. Please note that we cannot accept online payment, and that you will have to mail a check to us once you have completed this form. Thank you.

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Title (e.g. Dr., Ms.):

First Name:

Last Name:

Job Title:

Institution:

Business Address:

City:

State:

Zip:

Country:

Phone:

Fax:

Email:

Home Address:

City:

State:

Zip:

Mail correspondence to:

	Business
	Home

Number of Years in Field:

Special Dietary Needs:

Nametag I would like my nametag to read:

Confirmation Mailing Address Final details about the Institute will be mailed to you in June. If your mailing address will differ at that time, please list that address here:

Fees: The Institute fee of $1565 per person includes all classes, instructional materials and meals with the exception of Monday and Wednesday evening dinners.

A $300 deposit is required to hold your place. Full payment is due by May 15, 2012.

Summer Institute on College Admissions Registration Form

June 17–22, 2012, Cambridge, Massachusetts Sponsored by Harvard University and The College Board

June 17–22, 2012, Cambridge, Massachusetts
Sponsored by Harvard University and The College Board