All students: Please make $250 check out to University of Minnesota and write Hydrocamp 2013 on the memo line.
Mail this completed form and deposit check to:

Dr. E. Calvin Alexander Jr.       2013 Hydrocamp Coordinator        University of Minnesota        Department of Earth Sciences         310 Pillsbury Drive SE       Minneapolis, MN 55455

Contact info: Tel: 612-624-3517 Fax: 612-625-3819 Email: alexa001@umn.edu http://www.geo.umn.edu/orgs/camp/hydrocamp

Once you have accepted admission to the Camp (see: How to Apply to Hydrocamp), the $250 deposit is non-refundable.

Name:_____________________________________________________________________________________
              Last or Family,                                          First                                                        Middle

Telephone: ___________________________       Gender (M/F)________________        Age: _______________________

Current Mailing Address:________________________________________________________________________________________________
                                       Number & Street                                              City                                                  State/Country                 Zip Code

E-Mail: __________________________________

Student Status: Circle one   <full-time>    <part-time>    <not currently enrolled>
   Expected Graduation Date and Degree: _____________________________________________

Employer or Department and University/College: ______________________________

University: U of MN Student I.D.: (if applicable)___________________________ Major/Year: _________________________

If you have taken any groundwater related courses (not required but useful), please list them here:
List course designator, course name, institution, year of completion, and grade:

_______________________________________________________________________________

_______________________________________________________________________________

Other relevant geology, hydrology, engineering, or environmental science courses:
List course designator, course name, institution, year of completion and grade:

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

Are you interested in the 4-undergraduate-credit (GEO 4971W) or 2-graduate-credit (GEO 5971) version of the course?

If the class is full, do you wish to be placed on a waiting list for this year?            for next year?

Do you need housing during the first week in the Twin Cities?
                 <Yes>    <No>

Are you coming by car thus needing parking (at extra cost) during the first week in the Twin Cities?
                <Yes>    <No>

Will you bring your own laptop (recommended)?
                <Yes>    <No>

Do you have any food requirements or preferences?
                <Yes>    <No>

How did you find out about this course?



             If you have heard about hydrocamp from a previous hydrocamp participant, please
             let us know who it is by entering as much info as you can below.

             Full Name:
             Current Mailing Address:
             Current E-mail Address:
             Participated in Hydrocamp Year:

Have you told others in your department about this course?
                <Yes>    <No>

Please provide any contact info of people you think would be interested in knowing about this course (continue on back if necessary).

Revised October, 2012