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Summer in the Rockies application

Introductory Physical Geology in the Rocky Mountains is a three-credit course.

The program cost of $1,400 includes tuition, transportation and all related field expenses. The program is limited to 12 students. Priority is given to incoming first-year Augustana students who have made a deposit for enrollment at Augustana College. New student registration for GEOL105 requires a $400 non-refundable deposit, sent along with the application below. The remaining $1,000 must be made by the July billing date.

Please return the lower portion of this form with your $400 non-refundable deposit as soon as possible after making your deposit for enrollment at Augustana College. This course usually fills by mid-May; call (309) 794-7318 or (309) 794-7304 for availability. Print this document and mail lower portion to:

Augustana College
Geology Department
Rocky Mountain Field Course
639 38th St.
Rock Island, IL 61201

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Application Form for Summer Field Course: Physical Geology in the Rocky Mountains


Name: _________________________________(______________)___________________
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Address: _________________________________________________________________
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Phone: (_____)________________ Cell Phone: (       )__________________________

 

E-mail: _____________________________________________________________________

How did you hear about this course?                                   What are your interests?

 

Sex: __ Male __ Female

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T-shirt size _________ (adult sizes S, M, L, XL)

Social Security Number: XXX - XX -_______ Birth Date _____/_____/______
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