2015 Leadership Enrichment Adventure Program

Registration Form

Please complete this form and hit "Submit". Office of Transitional Programs will email you more specific information about your preferred LEAP session as early as May 1, 2015. Please note that students do not have a guaranteed placement in their preferred LEAP session until payment is received and confirmed via email ($250 for both the Science Immersion and Service Immersion sessions, and $300 for the Outdoor Immersion session.). Each session of LEAP can accommodate a maximum of 15 students.

Name
Gender Male    Female
Parent(s) or Guardian(s) Names
Home Address
City
State
Zip Code
Email Address
Phone Number
T-Shirt Size (Adult sizes):
Do you have special dietary needs? (food allergies, vegetarian, etc.)
 
Do you plan to arrive a day early?
Yes
No
Unsure at this time
If yes, Drury's Housing Office will charge you an additional $15 to stay on campus.
 
Sign me up for the following LEAP trip:
Service Immersion - Saturday, June 27 - Tuesday, June 30, 2015
Science Immersion - Saturday, June 27 - Tuesday, June 30, 2015
Outdoor Immersion - Tuesday, July 7 - Friday, July 10, 2015