Alaska Wrangell Mountains Field Studies, Summer 2019 Student Application Form

Please fill out the form below completely. For Evergreen State College students, note the two-day earlier start date than regular summer session. In addition, please send (via email or mail) a full, unofficial or official transcript to Dr. Ken Tabbutt (tabbuttk@evergreen.edu). Mailing address is:

Dr. Ken Tabbutt
Lab 2, The Evergreen State College
2700 Evergreen Parkway, NW
Olympia, WA 98505

Name *
Name
Date of Birth *
Date of Birth
Telephone Number *
Telephone Number
Address *
Address
Parent/guardian name, if under 21
Parent/guardian name, if under 21
Parent/guardian phone, if under 21
Parent/guardian phone, if under 21
Parent/guardian address, if under 21
Parent/guardian address, if under 21
At which undergraduate educational institution are you currently enrolled as a student?
What are you majoring in at your university? You can enter "undecided" if applicable.
Please let us know, using complete sentences, why you are interested in participating in the field studies program and what you hope to gain from the summer. Explain how this field studies program supports your educational objectives, personal growths and interests.
Reference name *
Reference name
Please provide us with the contact information of your academic advisor, or a faculty member who can act as a reference
Reference phone number *
Reference phone number
I would like to be considered for a scholarship
I certify that all answers to the preceding questions, including the information in the essay, are true and correct. I understand that false answers or deliberate omissions may be grounds for rejection of the application.