Parent/Guardian Approval

It is required by The Johns Hopkins University that parents and/or guardian(s) sign this application form.

I approve of this application and will permit (name)_______________________________to attend the Summer
Program at The Johns Hopkins University. If he/she is accepted and enrolled, I agree to pay tuition costs
and residential/commuter fees. I recognize that refunds can only be made according to the refund schedule stated
on the Summer Programs website. I understand the necessity for his/her conformance to the academic and social
policies of the program and of The Johns Hopkins University and that failure to abide by these regulations may
result in his/her dismissal.

For All Students:

Signature of mother/guardian Date -

Print name -
Address -
Work phone ( ) Home phone ( ) Email -

Signature of father/guardian Date -

Print name -
Address -
Work phone ( ) Home phone ( ) Email -

For Commuter Students Only:

Signature of local guardian Date -

Print name -
Address -
Work phone ( ) Home phone ( ) Email -

Agreement of Applicant
If admitted to the Johns Hopkins Summer Programs, I agree to abide by the academic and social policies of the
program and of The Johns Hopkins University. I understand that failure to abide by these regulations may result in
dismissal.

Applicant’s signature Date -