Marine Biology Camp Session 1

What high school do you currently attend?*

Expected High School Graduation Date*

School Counselor Name*

School Counselor Email*

School Counselor Phone*

Parent Information

Parent/Guardian 1 Name*

Parent/Guardian 1 Email*

Parent/Guardian 1 Mobile Phone*

Parent/Guardian 2 Name

Parent/Guardian 2 Email

Parent/Guardian 2 Mobile

May we text you?

Yes, please

No, thank you

Fellowship Opportunity

You are eligible for fellowship to offset the cost of the Marino Bio Camp Program fee if you meet one or more of the following criteria:

You are enrolled in or eligible to participate in the federal free or reduced price lunch program.
You have received or are eligible to receive an SAT or ACT fee waiver.
Your annual family income falls within the income eligibility guidelines set by the USDA Food and Nutrition Service.
Your family receives public assistance.
You are enrolled in a federal, state, or local program that aids students from low-income families (e.g., GEAR UP, TRIO such as Upward Bound or others).
You live in a federally subsidized public housing, a foster home or are homeless.
You are a ward of the state or an orphan.
You have received or are eligible to receive a Pell Grant.
You can provide a supporting statement from a school official, college access counselor, financial aid officer, or community leader.

Do you meet one or more of the fellowship eligibility criteria?*

Yes, and I wish to be considered for a fellowship and I will forward documentation of eligibility as soon as possible

Yes, but I do not wish to be considered for a fellowship

No, I am not eligible for fellowship consideration

There are a limited number of fellowships available to offset the cost of the MBIO camp program fee for registrants that qualify for any of the above eligibility criteria. Fellowships would offset costs anywhere from $675-$1335. If you wish to be considered for a fellowship, please request a letter from your child’s school, documenting their eligibility for the free lunch program, provide a brief statement of financial need (emailed to: summer@rwu.edu with the subject line, “MBIO Camp Fellowship”, and submit the $500 deposit.)

Summer Camp Registration Fee

A $500 deposit is required upon registration (refundable before April 1). Please enter your payment credentials below before submitting the registration form.

Amount Due
Transaction Fee	Dependent on selected payment type
Total	Dependent on selected payment type
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Amount Due

Transaction Fee

Dependent on selected payment type

Total

Dependent on selected payment type

Signature

Student's Signature*