2021 RegistrationInstructionsandChecklist the Pre-CollegeProgram(PC)andmaynotusethisform(FormA).See on inactivated. email register To All c status. graduate credit. old years 15 be must sessions) il e rpe fo al courses, all from dropped be 17will May by full in paid not have who Students immediately. account services online their in fees and tuition of payment full make forms lost in transit. Additional registration forms may be downloaded from the Summer School website. When completing registration forms, please clearly print clearly please forms, full your write and information registration completing When website. School Summer the from downloaded be may forms registration Additional transit. in lost forms Instructions For f You are responsibl are You including waitlists. Office byMay17 High M Harvard Colleg Un I-20 I Ukrainian SummerInsti husi-admissions that your email address has been rejected by the email host, we will inactivate that email address in our system. Similarly we will inactivate a postal mailing address if address mailing postal a inactivate will we Similarly system. our in address email that inactivate will we host, email the by rejected been has address email your that As part birth, emailaddress,andcurrentpostalmailingaddress. mail nsurance isun i li n dergraduates whoareunder18yearsoldmustregisteronpaperanmustsubmitofficialletterfenrollmentrom ne Students wh Students Policy. Age imum ritica to thataddressisreturnedasnotdeliverable.YoumayupdatecontactinformationonlinebyloggingintoyourMyDCEaccount. If youcannotregisteronline,mayonpaper.Donotsubmitmultiplecopiesofthesameform.Toseeyourcourseregistrationconfirmation,loginto school students Certificates drs ta i uiu ad o sae wt ay te pro wti te iiin f otnig dcto suet aaae Dpiae mi adess il be will addresses email Duplicate database. student Education Continuing of Division the within person other any with shared not and unique is that address

courses, you must maintain an active email address throughout your enrollment. To protect the privacy and security of your student records, you must provide an provide must you records, student your of security and privacy the protect To enrollment. your throughout address email active an maintain must you courses, a of registration, 51 Brattle Street, Cambridge, 02138-3722•summer.harvard.edu Massachusetts ice, ster ser l you must complete Form A and submit it to Harvard Summer School, 51 Brattle Street, Cambridge, MA 02138-3722. The Summer School is not responsible not is School Summer The 02138-3722. MA Cambridge, Street, Brattle 51 School, Summer Harvard to it submit and A Form complete must you Summe . Formsmaybedownloadedfromthewebsite(htt a e studentswhohavewithdrawn vailable for .html. are e r for maintaining ac maintaining for currently completingthe Sc v not you mustprovideyourfulllegalname(exactlyasprintedonpassportor h o t u o t l vial for available the 2021term. name on every form. Be sure to sign and date those forms that require your signature. For forms received after May 17 May after received forms For signature. your require that forms those date and sign to sure Be form. every on name legal e applicantsmustfirstsubmita at the time of registration of time the at a n no r egister on o have completed have o unc ements, suchas cu rate contact in contact rate I Please leavethe nternational students or 10th, 11th,or12thgrades,includingthosegraduatingthisyear,mustapplytotheSecondarySchoolProgram(SSP) ar line w hi e o to enroll for noncredit and undergraduate credit; students must be 18 years 18 be must students credit; undergraduate and noncredit for enroll to gh school and are planning to regist to planning are and school gh n cl leave mustsubmitacomp fo ass rmation In MyDCE at ith ac cancellations, surance section p sepa s://registra s rat um (email address, postal address, telephone numbers) with the Summer School. If we receive notice receive we If School. Summer the with numbers) telephone address, postal address, (email o te 2021 the for e Uk summer.harvard.edu/login. mer.harv redit c rainian SummerInstituteapplication,avail r

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02.21 sum_reg.pdf 2021 ❏ ❏ R

deadline for full payment. Checks should be payable to Harvard University. See the website for more information on payment options and policies. and options payment on information more for website the See University. to Harvard payable be should Checks payment. full for deadline with a credit card or e-check. MasterCard, Visa, American Express, and Discover are accepted. Wire payments should be sent no later than April than later no sent be should payments Wire accepted. are Discover and Express, American Visa, MasterCard, e-check. or card credit a with P Full paymentisdueMay17 ll payments must be in US currency, payable through US banks. The Summer School does not accept cash payments. Payment may be made online at online made be may Payment payments. cash accept not does School Summer The banks. US through payable currency, US in be must payments ll e ay gistration Formgistration Checklist RegistrationInstructionsandChecklistcontinued requested forSummerSchoolcompliancewiththeTaxpayerReliefActof1997.IfyouhavenoUSSocialSecurity/TaxpayerIDnumber,leavethatsectionblank. online P FORM a m yme ent servicesaccounttocompletepayment. A: HarvardSummerSchool2021RegistrationForm.FormAisrequiredunlessyouregisteronline.YourUSSocialSecurity/TaxpayerIDnumber (if available)is n t. Onceyoureceiveemailconfirmationthatouregistrationformhasbeenprocessed,select“StudentFinancePortal”romhemainmenuo . IfyoudonotpayinfullbyMay17,riskbeingdroppedfromallcoursesandwaitlists. INSTRUCTIONS—Page 2 summer.harvard.edu 9 to meet the May 17 May the meet to

02.21 sum_reg.pdf PLEASE CLEARLY PRINT ALL INFORMATION ❑ * Country (if not US) not (if Country City Street and number (including apartment number) ❑ In addition, please select oneormore of thefollowing racial categories to describe yourself: PERMANENT ADDRESS PERMANENT ADDRESS MAILING PRESENT ❑ ❑ Do you consider yourself to beHispanic/Latino? ETHNIC CODE Country (if not US) not (if Country City Street and number (including apartment number) US SOCIAL SECURITY/TAXPAYER ID NUMBER (if available)* SECURITY/TAXPAYER NUMBER ID SOCIAL US Leg ❑ ❑ EDUCATION (checkhighestlevelasof6/2021) STUDENT FULL LEGAL NAME NUMBER ID DCE Last/Family/Sur name(s) ❑ ❑ HEALTH INSURANCE ❑ insurance coverage health check the box School below and provide Summer your the insurance to waive information. order In session. a 3-week for $100 session; 7-week the for $200 fee: insurance a health charged and plan School automatically Summer the in enrolled be will insurance School Summer the waive not do who Students US. the within accidents and illnesses major covers that insurance have they leave this section blank and check here: here: check and blank section this leave then TIN or SSN no have you 1997. of If Act Relief Taxpayer the with comply Your US Social Security (SNN)/Taxpayer ID Number (TIN) is required to to required is (TIN) Number ID (SNN)/Taxpayer Security Social US Your @ Parent/Guardian signature S I

certifythat I do not have a SSN or TIN or aSSN have not I do

tudent signature tudent (3) (2) (1) (1) information at right. policy insurance my providing I am School insurance. Summer the waive to Iwish and US the and accidents in covers major illnesses that insurance I have (5) Female Male a l sex

(see summer.harvard.edu/login if unsure)

Black or African American Black Some highschool American Indianor Alaskan native Asian Bachelor’s degree* 2021 RegistrationForm I DATE OF BIRTH (voluntary; US citizens and permanent residents only) amcurrently Month ( Month (if known)

_ - ______. Students enrolled in Summer School, both US residents and nonresidents, are required to purchase insurance through the Summer School unless mmm (if different frompresent mailingaddress) (PR) Student's relationship to policyholder Policy number Subscriber name Carrier insurance fee as described above.) PRIMARY INSURANCE PRIMARY )

______participating in, (exactly as printed on your passport or other government-issued photo identification) (MA)

example: ❑ ❑ Day(

- (6) (2) dd

High school diploma Master’s degree* J ) A ❑ ❑ N

andwillcontinuetopartici (5) (4) 0

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OR (If this information is incomplete, you will be enrolled automatically in the Summer School insurance and charged the health health the charged and insurance School Summer the in automatically enrolled be will you incomplete, is information this (If White Native Hawaiian orother Pacific Islander ❑ 1 Year ( Year 9

9 Yes HARVARD ID NUMBER NUMBER ID HARVARD 6 yyyy

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(7) (3) CITIZENSHIP CITIZENSHIP ❑ ❑ ❑

First/Given name(s) Doctorate* Some college (F) (P) (Y) pate in,theabovenamedplanthroughout (If “Yes,” you also must submitForm IM.) Will you beattending Harvard SummerSchool ona visa? Native language Country of citizenship

(if known) International student US permanentresident US citizen (check one) ______Reserves? or Guard, National Guard, Coast the including military, US the in duty active on serving currently you are or Veteran Military aUS you Are STATUS MILITARY US If “yes”, check one: “yes”,If check ______Cell phone number (area/country code) State/Province Telephone number (area/country code) State/Province ❑ ❑ PROGRAM * orequivalent f ❑

Proctor (PR) Proctor General program (GP) (4)

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No Good until: (Month—Day—Year) Middle name(s)

❑ ❑ Date Date

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Continued on next page. next on Continued Yes

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02.21 sum_reg.pdf 2021 Country (ifnot US) City Street andnumber(includingapartment number) HARVARD DEGREE CANDIDATES Last/Family/Sur name(s) EMERGENCY NOTIFICATION INFORMATION ADDRESS EMAIL Last/Family/Sur name(s) STUDENT FULL LEGAL NAME (each 4-credits=$3,400) Full tuitionpayment remaining balanceisduebyMay17.) with yourregistration(Fullpaymentofany due payment minimum Total required 5-digit course reference no. (CRN) STATUS:CREDIT ENROLLMENT: MAXIMUM (see 1) page fee insurance Health session(s) your for fee housing School Summer by May 4) May by (due I-20 certificate School Summer Harvard a requesting charges) if School Summer A School (check one): (Noncredit) dvance Payment (applied toward total total toward (applied Payment dvance * Signature false orwhoviolatesSummerSchool policiesandprocedures,includingcancelingthestudent’s registrationandrequiringthewithdrawalofstudent. Summer Schoolwebsite.Iunderstand thattheSummerSchoolreservesrighttotakedisciplinary actionagainstanystudentwhoseinformationis mer Schoolbymeoronmybehalf. Icertifythattheinformationistrueandcomplete.agreetoabide bythepoliciesandproceduresdetailedon STUDENT SIGNATURE:BysigningI,thestudent,agreetofollowing:Iacceptfullresponsibility forallinformationaboutmesubmittedtotheSum ❑ ❑ ❑ ❑ ❑ ❑ Credit statuscodes: SummerSchoolRegistrationFormcontinued

MED GSAS EDU DES BUS Harvard College F or any questions regarding payment, please contact StudentFinancial Services at [email protected] or(617) 495-4293

❑ ** ______❑ ❑ ❑ ❑ Tution:

(must be student’s personal and unique address) (SEL) address) unique and personal student’s be (must Write one code for each course. Choose from options in course description. (See key*) (See description. course in options from Choose course. each for code one Write SPH LAW GOV DIV DEN

Required payment due with Form A. Login to your online services account to make payment. account services online to your Login Form with due A. payment Required

Received onorbeforeMay17 4-creditcourse=$3,400. 8-creditcourse=$6,800. UN(Undergraduate)•GR(Graduate)NC

8 credits Subject (exactly as printed on your passport or other government-issued photo identification) (other than Harvard Extension School) ❑ ❑ ❑ ❑ ❑ ❑ required ** AllstonBurrResidentDeanform Student status (check one): S Specialstudent (S) (G) New (N) Degreecandidateonleave** (L) withdrawn** Degreecandidate (W) Activedegreecandidate (C) Digital signature not accepted. Document must be signed with a real signature. areal with signed be must Document accepted. not signature Digital S- S- Subject number Graduate, (EM) candidate, $ $ $ $ $ 20 20–2021 Course title (and section number, if applicable) if number, section (and title Course 2021–2022 First/Given name(s) 1,500 First/Given name(s) (see 1) page fee insurance Health with forms Full payment due (from above)(from payment Full tuition STUDENTS FROM OTHER US COLLEGES AND UNIVERSITIES AND COLLEGES US OTHER FROM STUDENTS School name ______Telephone number(area/country code) State/Province

Received afterMay17 Middle name(s) Date Tuition total CEEB code ______(UN, GR, NC) Credit status* Zip/Postal code (if known) $ $ $

FORM A—Page 2 A—Page FORM Tuition** $ -

02.21 sum_reg.pdf