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In order to facilitate the billing and registration process, please complete the form below and send it to the Governor's Institutes with your students' application forms by April 1. Please list your students in priority order.
You can nominate students for each Institute. At least 5 will be accepted: (2) Arts,
(1) Science or Engineering and (1) Current Issues or Asian Cultures
(1) Information Technology. 30 students will be accepted into Mathematics.
| Name of Student |
Program |
| ________________________ |
Arts ($850) |
| ________________________ |
Arts ($850) |
| ________________________ |
Asian Cultures ($550) |
| ________________________ |
Current Issues & Youth Activism ($850) |
| ________________________ |
Engineering ($550) |
| ________________________ |
Information Technology ($550) |
| ________________________ |
Mathematics ($300) |
| ________________________ |
Science & Technology ($550) |
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| OTHER STUDENTS TO BE CONSIDERED IF THERE IS SPACE AVAILABLE:
(Please list in priority order on separate sheet.) |
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| SCHOOL: __________________ |
PHONE: _________________ |
| SCHOOL CONTACT: ____________________________ |
EMAIL: ____________________ (please write clearly) |
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School Fee Due: ________
(# students x $150, with maximum of $600 per school) |
Amount School is Contributing Toward Student Tuition (*): ________
* (Please attach sheet with explanation) |
Total Due: ________
(school fee plus any contribution toward tuition) |
Questions? Please contact Jean Olson at (802) 229-4757 or giv@sover.net.
Print, fill out, and send this form to:
Governor's Institutes of Vermont
660 Elm Street
Montpelier, VT 05602
Thank you to all of you for your work to support students to attend Governor's Institutes!
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