Southwestern
   Adventist University
Minicamp
Application
for the

Dinosaur Project


Earth History Research Center  
 
for the summer 2017 expedition
 
Please make certain that all required information is supplied.   Double check all spelling.     * required data

Group Leader Personal Information

Name
 *      *    
   First Name Middle Initial   Last Name   Suffix   Title

Date of BirthGender
 *  *  *    *
   Month   Day   Year 

Address
 *  *      
   Street   City   State   Zip/Postal Code   Country (if not USA)

E-mail Phone Religious Affiliation
 *    *    

Institutional or Group Affiliation
 

Accompanying Adults

   First Name   Last Name   Birthday   Gender
1          
 
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3          
 
4          
 
5          
 
6          

If there are more names in your group, please submit an additional Application form with the remaining names.

Participants

   First Name   Last Name   Birthday   Gender
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If there are more names in your group, please submit an additional Application form with the remaining names.

Other Attendees

(family members, etc. that are attending but not planning to supervise or participate)

   First Name   Last Name   Birthday   Gender
1          
 
2          
 
3          
 
4          
 
5          
 
6          

If there are more names in your group, please submit an additional Application form with the remaining names.

Dates

 The 2017 expedition leaves Southwestern Adventist University in Keene, Texas, Thursday morning, June 1 arriving the next day at the project site.
 The expedition returns to Southwestern Adventist University in the afternoon of Friday, June 30.

Check the date you are planning to arrive at the site and the date you are planning to depart—(You only need to check these two dates—it is not necessary to check all the intermediate ones!):

 
June 2017
SMTWTFS
   
      
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Additional Information

Notes, comments, explanation, exceptions, or other information concerning this application for your participation: