Seattle Language and Culture Institute Registration for U.S. Participants

This form is for local participants based in the Seattle area who are interested in the day program (9:00am-5:00pm). For information about attending the Seattle Language and Culture Institute as a residential participant, please click here.

After you complete your registration, you will be sent to a page with a payment link to pay by credit card. Tuition is $550 per participant, with partial scholarships available; apply for a 50% scholarship by filling out the form here (please complete the registration form below as well). If you wish to pay by check, please make your check payable to FIUTS and mail to: Ellen Frierson, FIUTS, University of Washington Box 352233, Seattle, WA 98195. Please include the name of the registered participant on the check. Payment is due by July 6.

 

 

First Name *
First Name
Last Name *
Last Name
Preferred Name *
Preferred Name
Date of Birth *
Date of Birth
Guardian Cell Phone Number *
Guardian Cell Phone Number
Guardian Home Phone Number
Guardian Home Phone Number
Guardian Work Phone Number
Guardian Work Phone Number
Parent/Gaurdian Name
Parent/Gaurdian Name
Parent/Guardian Cell Phone
Parent/Guardian Cell Phone
Parent/Guardian Home Phone
Parent/Guardian Home Phone
Parent/Guardian Work Phone
Parent/Guardian Work Phone
Doctor's Phone Number *
Doctor's Phone Number
Emergency Contact Name *
Emergency Contact Name
Please provide the name of an emergency contact other than a parent/guardian.
Emergency Contact Phone Number
Emergency Contact Phone Number
How will the participant travel to/from the University of Washington campus each day? (Students will meet each morning at 9 AM and conclude most afternoons by 5 PM.) Select all that apply. *
This section should be filled out by the student participating in the Seattle Language and Culture Institute.
This section should be filled out by the student participating in the Seattle Language and Culture Institute.
This section should be filled out by the student participating in the Seattle Language and Culture Institute.
This section should be filled out by the student participating in the Seattle Language and Culture Institute.
This section should be filled out by the student participating in the Seattle Language and Culture Institute.
This section should be filled out by the student participating in the Seattle Language and Culture Institute.