Summer Nursing Camp - University of Maine at Fort Kent

June 24 to June 28, 2012
Sponsored in partnership with
Northern Maine Medical Center

Students must be entering their Senior, Junior or Sophomore year in the Fall of 2012 in order to participate. The camp fee is $300. Upon receipt of your online registration, a complete package will be mailed to you at the address provided below. For more information about the camp, please view the Nursing Camp Brochure here.

All fields not indicated as optional are required.

Registrant Name:	(Person Attending Camp)
Billing Name:	(Name on Credit Card)
Grade Level (Fall 2012):
Street/PO Box:
City/Town:
State:
Zip:
Country:
Phone Number:	(e.g. 555-555-5555)
Cell Phone (optional):	(e.g. 555-555-5555)
E-mail Address:
Parents' Names:
Upon submission of this form, you will be brought to our secure payment gateway to complete payment for your registration. A minimum payment of $50 is required to complete your registration. If you do not pay your registration deposit, your registration will NOT be completed, and a position will not be held for you. Your registration will only be completed and submitted once your payment is complete.