Online Registration

About the Student
First Name of Student:
 
Last Name of Student:
 
Gender:
 
Academic Information
Grade student will be in next year:
 
Name of School:
 
Name of achievement test:
 
Test scores (verbal/math):
 
Teacher E-mail:
 
Parent & Contact Information
Last Name of Parent:
 
First Name of Parent:
 
Address:
 
City:
 
State:
 
Zip:
 
Student E-mail Address:
 
Parent E-mail:
 
Primary Phone:
 
Secondary Phone:
 
   
Other Information
Special Considerations:
 
How and where did you learn about our program? (Please specify where)
 
   
Staff Only
Paid:
 
Entered
 
   
   

A $200 deposit is required with the pre-registration form. The remainder is due at check-in on campus, June 15. The deposit is refundable only up to June 1, 2014. No refund can be made after the program begins, and no credit cards are accepted.

Check is to be made payable to: Wesleyan Summer Gifted Program.

Mail pre-registration form and deposit to:
Wesleyan Summer Gifted Program
Box 122
West Virginia Wesleyan College
Buckhannon, WV 26201

Phone: 304-473-8072 E-Mail: sgp@wvwc.edu