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Campus Camp Wellstone Online Registration
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First Name
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Your answer
Last Name
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Your answer
What is your current address?
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Street Address
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City
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Your answer
State
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Your answer
Zip Code
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Your answer
Email address
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This will be used to send updates and details
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Telephone number
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What school do you currently attend?
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Your answer
What is your age?
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Your answer
What grade will you be entering for the '12-'13 academic year?
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Your answer
Are you attending Campus Camp Wellstone as part of an organization or club?
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Yes
No
If yes, what is your organization or school club?
Your answer
Do you plan to attend the Saturday night social?
*
Meet local artists who use their work for social change; optional event
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No
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There are a limited number of scholarships available upon request. Please check the box if you would like more information on housing scholarships.
I would like more information.
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