Florida Atlantic University



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| |Tiffany Frost |

|SF Collab Lab |Department of English (CU 306) |

|Intensive Creative Writing Summer Camp Summer 2019 |Florida Atlantic University |

| |777 Glades Road |

| |Boca Raton, FL 33431 |

| |(561) 297-2974 |

|CONTACT INFORMATION |

PLEASE PRINT in black or blue ink

_____________________________ ____________________ _____

|Last Name |First Name |M.I. | |

___________________________ ________________________ _______ ______________

|Current Mailing Address |City |State |Zip |

(_______) _______ - _________ (_______) _______ - _________

|Contact Telephone (Permanent) |Contact Telephone (Secondary) | |

____________________________________ _____________________________________

|E-mail (Primary) |E-mail (Secondary) |

|CAMPER INFORMATION |

PLEASE PRINT in black or blue ink

_____________________________ ____________________ _____

|Last Name |First Name |M.I. | |

(_______) _______ - _________ (_______) _______ - _________

|Contact Telephone (Permanent) |Contact Telephone (Secondary) | |

____________________________________ _____________________________________

Email (Primary)

|Summer Camp |

|SF Collab Lab: |M-F |9 am-4 pm | |Room #: TBD | |Begins |June 24, 2019 |

| | | | |Boca Campus | |Ends |June 28, 2019 |

|Instructors: TBD | | | | |

|FEES & PAYMENT |

Payment must accompany this form to be registered for class and will be accepted via check or money order payable to Florida Atlantic University in the amount of $290. Fees are not refundable. Fees include the cost of literary magazine the campers will published. Application and payment must be received by June 17 2019. Seating in each class is limited and enrollment is granted on a first come, first serve basis.

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