Summer Bridge 2012 Online Registration
	The form below is for both NEW students to AIS and current AIS students.

	Online Registration Form
	Summer Bridge is a fun orientation program that explores math, science, humanities and drama. There are neither tests nor homework.   The program runs from July 9-12 and July 16-19, 10 a.m. to 3 p.m. There are no Friday sessions.   Current AIS students may sign up for one week only. Students NEW to AIS should sign up for both weeks.   Cost: $150 per week Lunch is provided. (Financial aid is available.)   Once you have submitted this form online, please write a check payable to The Haverford School, and mail to the attention of Deanna Mayer, AIS Dean of Students, at The Agnes Irwin School, Ithan Avenue and Conestoga Road, Rosemont, PA 19010-1042.
	Student First Name Student Last Name Parent/Guardian1 Name Preferred Phone1 Preferred Email1 Parent/Guardian2 Preferred Phone2 Preferred Email2 Emergency Contact1 Name Home Phone1 Work Phone1 Cell Phone1 Emergency Contact2 Name Home Phone2 Work Phone2 Cell Phone2 Student Medical Concerns Indicate New or Current Student New Student Current Student Indicate Week/s Attending Both weeks July 9-12 July 16-19