2025 Enrollment Edit Request Form

2025 Summer Internship Program Enrollment Edit Form

Please use this form if there are any edits you would like to make to your enrollment to our 2025 Summer Internship Programs
Student Information
Student Name

First NameLast Name
Student Email
example@example.com
What program are you or your child enrolled in?
Criminal Law & Trial Internship Dates
Advanced Law & Justice Reform Internship Dates
Advanced Medical Neuroscience Internship Dates
Advanced Medical & Public Health Internship Dates
International Leadership & Business Internship Dates
National Security & Diplomacy Internship Dates
Cybersecurity & Defense Internship Dates
Public Policy & Political Action Internship Dates
AI & Emerging Technology Internship Dates
Middle School Jumpstart Program Dates
What would you like to update in your enrollment?
Please note, all session updates are subject to availability. This form does not guarantee that your program will be switched. The change is not finalized until you receive an email confirmation from mbailly@lichange.org.
Updated Program Choice
Updated Criminal Law & Trial Internship Dates
Updated Advanced Law & Justice Reform Internship Dates
Updated Advanced Medical Neuroscience Internship Dates
Updated Advanced Medical & Public Health Internship Dates
Updated International Leadership & Business Internship Dates
Updated National Security & Diplomacy Internship Dates
Updated Cybersecurity & Defense Internship Dates
Updated Artificial Intelligence & Emerging Technology Internship Dates
Updated Middle School Jumpstart Program Dates
Whose contact information are you changing?
Student Information: What do you wish to change?
Updated Student First Name
Updated Student Last Name
Updated Student Email
Updated Student Phone Number
Parent/Guardian 1: What do you wish to change?
Updated Parent/Guardian 1 First Name
Updated Parent/Guardian 1 Last Name
Updated Parent/Guardian 1 Email
Updated Parent/Guardian 1 Phone Number
Parent/Guardian 2: What do you wish to change?
Updated Parent/Guardian 2 First Name
Updated Parent/Guardian 2 Last Name
Updated Parent/Guardian 2 Email
Updated Parent/Guardian 2 Phone Number
Payer: What do you wish to change?
Updated Payer First Name
Updated Payer Last Name
Updated Payer Email
Updated Payer Phone Number
Other: What other contact information would you like to be updated?
What other information would you like to be updated?
Additional notes or concerns:
Should be Empty:

2025 Summer Internship Program Enrollment Edit Form

Student Information