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7 East 12th Street New York, NY 10003

Summer Application

Summer Institute at the NYU School of Continuing and Professional Studies for High School Students
Application Submission Instructions (Application deadline June 15, 2013.) Please fill in this application electronically and e-mail it as a PDF attachment to scps.summerinstitute@nyu.edu. You will receive a confirmation e-mail once the completed application has been received. IMPORTANT: If the application form opens in your browser window, please save or download the form to your computer. You can view and print this form in PDF format by installing ADOBE ACROBAT READER if you do not already have it on your computer. Its free. If you have any questions, please call (212) 998-7006.

1. Contact Information

Please fill in the information below. The e-mail address you supply will be our primary form of communication. Be sure to provide an e-mail address that you check frequently. The permanent street address that you provide will be used to send official university documentation, including transcripts.

Last Name: Middle Name: E-mail Address: Street Address: City: Home Phone: 2. Demographic Information Date of Birth (MM/DD/YYYY): Are you a United States Citizen? 3. Ethnic Background Yes No State:

First Name: Suffix:

Zip: Mobile Phone:

Gender:
(If you plan to apply for housing, you must indicate your gender)

Note: This program does not qualify an individual for study on the F-1 (Student) Visa at NYU-SCPS. This information is optional. No information you provide will be used in a discriminatory manner.

1) Are you Hispanic or Latino? Yes, I am Hispanic or Latino No, I am not Hispanic or Latino

4. Housing

2) What is your race? Select one or more. American Indian or Alaska Native Asian Black or African American Native Hawaiian or Other Pacific Islander White Prefer to Not Respond

I will reside in NYU housing for the duration of my program. I will not reside in NYU housing during the duration of the program. 5. Parents/Guardians (only one required) I hereby agree to give my son/daughter permission to enroll in the Summer Institute at NYU-SCPS for High School students. Parent or Guardian Father Mother Guardian Name (First and Last): E-mail Address: Daytime Telephone: Check here if parent/guardian is employed by NYU Check here if parent/guardian attends or  attended NYU I agree Parent/Guardian Signature: Date: Parent or Guardian Father Mother Guardian Name (First and Last): E-mail Address: Daytime Telephone: Check here if parent/guardian is employed by NYU Check here if parent/guardian attends or  attended NYU I agree Parent/Guardian Signature: Date:

You must acknowledge that you understand and accept the above terms by checking the I agree box and by entering your name and the date. Bydoing so you are providing your electronic signature which will serve as your confirmation of the accuracy of the data you enter on this form, and that you understand that this application is subject to the same terms and conditions as a paper-based application.

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Summer Application
6. High School Information Anticipated Graduation Date: (Month/Year) School Name: Street Address: City: Phone: 7. High School Transcript Please mail official high school transcript to: NYU-SCPS Summer Institute 7 East 12th Street, Room 1225 New York, NY 10003
Your high school transcript is required for your application to be considered complete.

State:

Zip:

8. Program Choice

Please check the box next to the program in which you want to enroll. If you are interested in more than one class, please rank your preferences on the lines below in descending order (1= most preferred):

SCHEDULE: Session 1 Monday, 7/15 Friday, 7/19 Photographing N.Y.C. Through the Minds Eye and the Camera Lens Digital Filmmaking Telling the Story Through Technology Real Estate N.Y.C. Building a Strong Foundation Digital Journalism Spreading the News Through New Media Finance N.Y.C. High Stakes, High Returns Session 2 Monday, 7/22 Friday, 7/26 Understanding Global Issues Tough Choices for the 21st Century Creative Writing Finding Your Muse in Metropolis Digital Filmmaking Telling the Story Through Technology Finance N.Y.C. High Stakes, High Returns Motion Comics and Illustration Transforming the Tale Real Estate N.Y.C. Building a Strong Foundation
You may apply to enroll in one or both sessions.

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Summer Application
9. Essay Question Please write an essay of no more than 250 words explaining why you want to study the subject area(s) you selected. If you have indicated more than one choice, include each choice in your essay. Write your essay in the space below, and then submit your application by following the instructions at the bottom of the page.

Application Submission Instructions (Application deadline June 15, 2013.) Please fill in this application electronically and e-mail it as a PDF attachment to scps.summerinstitute@nyu.edu. You will receive a confirmation e-mail once the completed application has been received. IMPORTANT: If the application form opens in your browser window, please save or download the form to your computer. You can view and print this form in PDF format by installing ADOBE ACROBAT READER if you do not already have it on your computer. Its free. If you have any questions, please call (212) 998-7006.

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