Chapman University

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Contact Information
First name
Last name
Gender	Male Female
Street address
City
State
Zip code
Email address
Phone
Parent / Guardian
Parent / Guardian Email

Education Information
High School
Interested Field(s) of Study
Grade Level

Workshop
T-Shirt Size:
Desired Session	I am not from Southern California and wish to be considered for a travel scholarship, which includes up to $500 reimbursement for travel expenses and room & board in Chapman residence halls for 6 nights.

Essay
Why do you want to attend the workshop? (800 words or less)


Bio
Please tell us about yourself.(500 words or less)


Feedback
How did you hear about the workshop? (100 words or less)

Teacher Recommendation
Please note: Your application is not considered complete until your Teacher Recommendation Form is also received. If it is received after the deadline, your application will be considered as space allows.
Name
Email address
Confirm email address

After submitting your application, you will receive instructions on where to have your recommendation form sent.
Once you press submit you will not be able to make changes to your application.