AU Summer Application Form for Academic Camps

Required fields (*)

If you are applying to an academic camp or institute, the following items must also be provided to the Office of Summer Programs in order for your application to be considered:
  • 2 letters of recommendation from teachers, on school letterhead.
  • Copy of an up-to-date transcript (to January 2018) or most recent report card.
  • A one-page essay telling us why you wish to attend this program (in your own words, with your signature at the bottom.)
  • List of math & science courses you've taken, if applying to Chemistry Camp.
  • Two samples of your writing (no more than 4 pages each; can be excerpts from longer works) if applying to Creative Writing Camp.
Send to Office of Summer Programs, Alfred University, 1 Saxon Drive, Alfred, NY 14802. Fax to 607-871-2045, or scan (PDF form only) and email to

I have read and understood that my application will not be considered complete until the Office of Summer Programs receives the additional materials indicated above.


Living Situation:

Deposit: 100.00

*Has camper attended our camps before?

If yes, which camp?:

*How is camper traveling to camp:

Basic Information:

*First Name:

*Last Name:

Camper's Mailing Address:




*Zip Code:


*Preferred First Name for Nametag:

Male Female

*T-shirt Size:

*Date of Birth (mm/dd/yyyy):


*Camper's Email Address:

*Camper's High School Name:

*Camper's High School Graduation Year:

Roommate Preference, if any (name):

AU Staff/Faculty Banner ID:
(AU Staff/Faculty will receive a discount when paying the final balance for academic camps.)
Please enter valid Banner ID to apply discount

Parents/Guardian's Name:

Mother's First Name:

Mother's Last Name:

Father's First Name:

Father's Last Name:

Guardian's First Name:

Guardian's Last Name:

Home Phone:
(ex. 607-123-1234)

Cell Phone:
(ex. 607-123-1234)

Work Phone:
(ex. 607-123-1234)

*Parent/Guardian Email:

Parent/Guardian Alt. Email:

Emergency Contact:

*First Name:

*Last Name:

*Relationship to Camper:

*Home Phone:
(ex. 607-123-1234 or enter N/A if none)

*Cell Phone:
(ex. 607-123-1234 or enter N/A if none)

*Work Phone:
(ex. 607-123-1234 or enter N/A if none)

*Emergency Email:

Payment Details:

Are Mailing and Billing address the same?
Yes No

*Account Holder's First Name:

*Account Holder's Last Name:

Middle Initial:

*Account Holder's Street:

*Account Holder's City:

*Account Holder's State:

*Account Holder's Zip Code:

*Please type what you see above: