Youth Mini-Camp application

Dinosaur Exacavation and Taphonomic Research Project

Southwestern Adventist University	Application to Dinosaur Mini-Camp Participation	Earth History Research Center
	for the 2009 expedition

Please make certain that all required information is supplied. Double check all spelling.

To be filled out by the Group Leader

Check one:

initial application (deadline May 1)

revised application

Group Leader:

Last name or Surname	First Name	M.I.	Suffix

Date of Birth:				Gender: Male Female
	Month	Day	Year		Title

Address:
	Street	City	State	Zip/Postal Code	Country

E-mail:

FAX:

Phone Numbers:
	Home	Cell	Work

Institutional or Group Affiliation:

Accompanying Adults

	Name: (last, first)	Gender		Age when arriving
1		Male	Female		new change delete
2		Male	Female		new change delete
3		Male	Female		new change delete
4		Male	Female		new change delete
5		Male	Female		new change delete
6		Male	Female		new change delete
7		Male	Female		new change delete
8		Male	Female		new change delete
9		Male	Female		new change delete
10		Male	Female		new change delete

Participants

	Name: (last, first)	Gender		Age when arriving
1		Male	Female		new change delete
2		Male	Female		new change delete
3		Male	Female		new change delete
4		Male	Female		new change delete
5		Male	Female		new change delete
6		Male	Female		new change delete
7		Male	Female		new change delete
8		Male	Female		new change delete
9		Male	Female		new change delete
10		Male	Female		new change delete
11		Male	Female		new change delete
12		Male	Female		new change delete
13		Male	Female		new change delete
14		Male	Female		new change delete
15		Male	Female		new change delete
16		Male	Female		new change delete
17		Male	Female		new change delete
18		Male	Female		new change delete
19		Male	Female		new change delete
20		Male	Female		new change delete

Other Attendees (family members, etc that are attending but not planning to participate)

	Name: (last, first)	Gender		Age when arriving
1		Male	Female		new change delete
2		Male	Female		new change delete
3		Male	Female		new change delete
4		Male	Female		new change delete
5		Male	Female		new change delete
6		Male	Female		new change delete
7		Male	Female		new change delete
8		Male	Female		new change delete
9		Male	Female		new change delete
10		Male	Female		new change delete

Select the date you plan to arrive at the site and the date you plan to depart.
Dates for 2009 season: leave Keene 4 Jun, arrive at site 10 Jun — leave site 26 Jun, arrive back at Keene 3 Jul

June 2009
S	M	T	W	T	F	S

			10	11	12	13
14	15	16	17	18	19	20
21	22	23	24	25	26

July 2009
S	M	T	W	T	F	S