2008 Kansas State Engineering ESSI Application

APPLICATION DEADLINE: APRIL 2, 2008
Open to high school students who have completed either their sophomore or junior year (graduates are not eligible).
THIS FORM MUST BE SIGNED BY PARENT OR GUARDIAN AND MAILED.
PLEASE PRINT, TYPE, OR FILL OUT THIS FORM ONLINE AND PRINT.

Student Information: All fields are required.

Name/SSN


First	MI	Last	SSN

Mailing Address

Street or PO Box


City	State	Zip

Contact


Home Phone (including AC)		E-Mail

Demographic

	M F
Age	Gender	Ethnicity	T-Shirt Size

Scholastic


High School Class	Cum GPA (thru 1/2008)

Special Needs
(physical/dietary, etc.)
or Comments

Parent/Guardian Information: All fields are required.

Name


First	MI	Last

Work Phone


AC		Extension

High School: All fields are required.

School

Full High School Name

Address

Street or PO Box


City	State	Zip

Phone


AC

A $100 deposit must accompany this application, or you may pay the full amount. Please make checks payable to the KSU FOUNDATION. Deposits will be returned only to those students not accepted into the program.

I have enclosed the following:
    Student Application Form
    Unofficial High School Transcript
    Standardized Test Scores (if available)
    Standardized Test Scores (if available)
    $100 Deposit -or- Full Payment of $295   $

REQUIRED!

Signature of Parent or Guardian ________________________________________________________

Print and return this application form, an unofficial transcript, test scores (if available) and deposit or full payment to:
    ESSI Director
    College of Engineering
    Kansas State University
    1046 Rathbone Hall
    Manhattan KS 66506-5201

Questions? Problems? Please contact Patty Berens paberens@ksu.edu. Phone: (785) 532-5590.
College of Engineering, Kansas State University, 1046 Rathbone Hall, Manhattan KS 66506.

ENGINEERING AND SCIENCE SUMMER INSTITUTE (ESSI)

MAY 26-30, 2008