Christendom College

Registration Form

ecsp-badge-color

REGISTRATION FORM

N.B. Use the “Tab” key instead of the “Enter” key in order to go from one line to the next.
Hitting the “Enter” key may submit the application prior to when you are intending to do so.

Select One Session (required)
Session 1: June 9-15Session 2: June 16-22Session 3: June 23-29Session 4: July 7-13Session 5: July 14-20

General Information

First Name (required)

Middle Name

Last Name (required)

Name you prefer to go by

Gender (required)

Date of Birth (mm-dd-yyyy) (required)

Student Email (required)

Student Cell Phone (required)

Street Address (required)

Street Address line 2

City (required)

State (required)

ZIP Code (required)

Home Telephone (required)

Name of Parent/Guardian (required)

Parent Cell Phone (required)

Parent cell number above belongs to (required)
MotherFatherOther/Guardian

Parent/Guardian Email (required)

Email address above belongs to: (required)
MotherFatherOther/Guardian

Student Religion (required)

Please list and explain any food allergies and/or dietary restrictions*If none, write N/A. (required)

*During the summer program, our kitchen staff is able to accommodate most common food allergies including gluten, dairy, shellfish, and peanuts, but, depending on the severity of an allergy, we may not be able to accommodate a student at the program. Please note that our college food service is not able to accommodate students with anaphylaxis. We are sorry for any inconvenience.

Please list any medical conditions if applicable*If none, write N/A. (required)

*Due to the strenuous nature of this program, students with epilepsy or a history of seizures will not be able to attend. Please note that, during the summer program, we are not able to accommodate students with anaphylaxis. We are sorry for any inconvenience.

How did you hear about this program?

Please write a statement (at least 200 words) describing yourself: hobbies, extra-curricular activities, interests, family life, sports, etc.. Also explain what you hope to gain from the Summer Program. This information will be very useful in helping to determine roommates!

Statement describing yourself (minimum 200 words) (required)

Education

Current School you attend full-time (required)

Type of School (required)

High School City, State (required)

Expected graduation date (month and year) (required)

T-Shirt Size: (required)

Payment Type

Important: To ensure your spot, please pay at the same time as you register. Otherwise, your spot is NOT guaranteed.

Program cost: $500

Select One (required)

Promo Code (if applicable)

Once you apply and pay, you will receive more information about the program, including an “Items to Bring” sheet, dress code and rules policies, a health form, as well as release forms that will need to be signed and returned. Clare McDermott is your main point of contact - ecsp@christendom.edu or 540-551-9187.

For those requesting financial assistance or using a promo code, you will receive an email from Miss McDermott with payment directions — please submit payment ASAP, otherwise your spot is not guaranteed.

Questions/Comments

Once you hit submit, you will receive an email from ECSP coordinator Clare McDermott. If planning to fly to Christendom, please wait for travel instructions from Miss McDermott before purchasing plane tickets because the college cannot accommodate students who arrive earlier (prior to Sunday) or leave later (after Saturday) than the program’s official start and end dates. Thank you!