Application for Summer Session 2011

Summer Session fees are due by June 27, 2011. A deposit of $150 per person is required on application. You will have an opportunity to make your Summer Session course selections on the next form. Applications are accepted until June 27. Apply early for the best choice of classes and accommodations. In case of cancellation, the deposit is forfeited after May 16, 2011.

Each student must complete a separate application.

PACE programs are open to adult Christian Scientists, alumni of Principia, and their spouses. Name
	First*	Middle Initial	Last*
I like to be called: I am an alum. I am a member of The Mother Church and/or one of its branches.

Home Address
Street*
City*		State*	Zip
Country:
Phone H*:	W:
E-mail*	Fax:

Alternate Address
Street
City	State	Zip
Country:
Phone:
Dates in use:

Emergency Information If in need, call (a relative, practitioner, friend)*

Home Phone:
Work or Cell Phone:

Accommodations* Please choose type of housing and length of participation (A/C=air conditioned)
		Two Weeks		Week One Only
				Week Two Only
	Two Weeks Price		One Week Price
Double non-A/C		$1,710		$998	per person
Double A/C		$1,940		$1,125	per person
Single non-A/C		$1,940		$1,125
Single A/C, small		$2,330		$1,410
Single A/C, large		$2,565		$1,550
Day Student		$835		$560
Please check if this is your first time at Summer Session. COUPLES: Would you prefer a room closer to the Men's or Women's bathroom?
Roommate Request I'd like to room with Choose a roommate for me. Travel Information for Summer Session I will fly to St. Louis. I will drive to Elsah. I'd like driving directions. Asterisk (*) indicates a required field