* Full  Name:
             
* Email:
* Current
Address:
* Phone#:   (Where I can be reached now)
  Cell Phone#: 
  Contact Time:    (Best to time to contact you)
  School Name:
  Year of Study:


  College Major:
  Position Desired:
      
             
  If Specialty, what areas of interest:
  Camper Age Preferred:

                 

  I am a:



    I am available for all Camp Dates        
(June 16,2017 until August 13, 2017)
    If NO, specify:
    Tell us something about yourself and how you heard of Wah-Nee.
   
   
    
     

 

 
 
 
 
 

Days: Hours: Mins: Secs: