Application - Cedar Valley Science Symposium | Wartburg College, Waverly, Iowa USA

CVSS Application

Applications must be received no later than January 7, 2013.

Name *
First Last
Class
Gender
Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Cell Phone or Other Phone
### - ### - ####
Email *
High School
High School City
High School State
Did you attend CVSS last year?
Do you plan to stay on campus Saturday night?
Do you plan to attend the Scholarship Day following CVSS (Sunday, Jan. 20)?

NOTE: Scholarship Days require acceptance to Wartburg and an invitation to attend. Contact the admissions office at 319-352-8264 for more information.
CVSS SESSION INFORMATION

In keeping the number of participants in each workshop of the symposium small, it may not be possible to give all applicants their first choice of subject area. Therefore, indicate below your top three choices. #1 will be considered your top choice.
#1 Choice
#2 Choice
#3 Choice
STATEMENT OF PLANS: State briefly your vocational plans after completing your formal education and your reasons for wishing to participate in this science symposium.

Notification of acceptance to participate will be e-mailed or mailed January 11.
A fee of $35 per participant will be collected at registration.