Summer Wilderness
Application Form

Your Name:

Preferred First Name:

Home address:

City:

State:

Zip:

Telephone (including area code):

E-Mail address:

Summer Mailing Address (if different from home address):

City:

State:

Zip:

Summer Phone (if different from home phone):

Dates Summer Address Applicable
From:     To:

Program Tuition:  June  $1,500    August  $3,000

Please rank 1-4 each program that you are interested in:

1  2  3  4   —   Adirondack Backpacking, June 19-28

1  2  3  4   —   Adirondack Canoeing, June 19-28

1  2  3  4   —   Alpine Backpacking, July 26 - August 20

1  2  3  4   —   Caribou Forest Canoeing, July 26 - August 20

Request Program Financial Aid
(for August Wilderness Only)?

Yes No

Financial Aid is need based as determined by the Earlham College Financial Aid Office. No additional paperwork is required.

To be considered for Financial aid, applications must be received no later than May 1, 2009.

Both August programs will require citizenship documentation to travel. If you are a U.S. citizen, you will need a government issued photo ID. For crossing the border in Canada, students will need a valid passport (Caribou Forest Canoeing program only). If you are not a U.S. citizen, bring bring your passport and have the proper visa for Canada.

Spaces on the program are reserved on a first-come, first-served basis. A deposit of $300 (which will be deducted from the tuition fee) reserves a place.

Link to: Refund and Financial Policies

In addition to submitting this online form, send tuition —
make checks payable to Earlham College — to:

Wilderness Program
Earlham College
801 National Road West
Richmond, IN 47374-4095

A confirmation letter or e-mail will be sent with detailed schedule information.