Camper Information Form

NIU 2016 LA&S Summer Academic Camps

Please fill out and submit each form listed below. After hitting submit, it will take you to the next form. When all forms are completed, you will receive an email within two business days with link to make deposit/payment for camp attending.

•Camper Information Form
•Parental Consent Form
•Behavior Contract Form
•Health Form
•Teacher Recommendation
•Student Personal Statement


Camper Information Form

Which camp is camper attending?
Camper's First and Last Name
Camper's preferred Name
2016/17 Grade
Street Address
ZIP Code
Parent/Guardian Name(s)
Parent/Guardian(s) Email
Parent/Guardian(s) Confirm Email
Parent/Guardian(s) Preferred Telephone
Parent/Guardian(s) Cell
Camper's Cell
Camper's Email
Roommate Request

Check box below and provide an explanation (required) if you have special needs that are regulated by the Americans with Disabilities Act. (Contact NIU's Disability Resource Center for assistance at 815-753-1303 or; particpants are responsible for any non-credit accommodation charges.)

Parent/Guardian(s) Signature (Initials)
Today's Date