Camps 2025

WIU Outreach Summer Camp Application

2025
PROGRAM PARTICIPATION IS CONTINGENT UPON THE FOLLOWING;
- AN ACCEPTED STATEMENT OF INTEREST
- COMPLETION OF REGISTRATION
- PAYMENT OF A $100 DEPOSIT
Program Participant Information
Participant's First & Last Name*

First NameLast Name
Camp scholarships have been made possible through the generosity of the WIU Foundation, WIU's College of Arts and Sciences and numerous local community organizations. Complete information on Outreach scholarships.
Select program needing to make a payment for:*

Art Grades 4-8 (June 9-13) Full Cost: $250Art Grades 9-12 (June 22/23-27) Full Cost: $350 commuter/$500 residentialGirls Plus Math Grades 6-8 (June 15/16-20) Full Cost: $350 commuter/$500 residentialCSI Grades 9-12 (2025 Dates TBD) Full Cost: $300 commuter/$450 residentialWestern Writers Grades 9-12 (June 22/23-26) Full Cost: $300 commuter/$450 residentialSTEM Grades 9-12 (July 6/7-11, 2025) Full Cost: $350 commuter/$500 residential
Address*
City *
State*
Zip Code *
Phone Number*

Area CodePhone Number
PARTICIPANT EMAIL (Please note, this is an email that program information will be emailed to and needs to be a monitored email address.) *
example@example.com
Age*
Date of Birth*
11/22/3333
Grade as of January 2025*
Gender (Answer decides roommate assignment.)*

FemaleMaleBorn female, identifies maleBorn male, identifies female
T-Shirt Size:*
How did you hear about our programs?*

Attended PreviouslyBrochureEmailFriend/FamilyTeacher/CounselorWebsiteSchool NewsletterOther
Program Participant's Statement of Interest

An accepted Statement of Interest is required for program attendace. It is to be completed by the participant attending the program. WIU's Office of Study Abroad & Outreach reserves the right to request for a Statement of Interest to be resubmitted.
Have you ever visited WIU's campus? If yes, for what?*
How did you hear about our summer camps?*
What interested you about this program?*

0/250
What are you looking forward to the most?*

0/250
Why do you think this summer program will benefit you?*

0/250
What are your plans for college? Feel free to include what universities you are considering, majors you are interested in and what you have been looking for when considering your post-high school plans. *

0/250
School Information
School Name*
School Counselor/Teacher Name
School Counselor/Teacher Email
example@example.com
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Phone Number (Include area code)
Parent/Guardian Information
Name*

First NameLast Name
Parent E-Mail*
Phone Number*

Area CodePhone Number
Additional Information:
Please indicate your method of payment:*

Credit Card - Submit payment below.Check - Make checks payable and send to: Western Illinois University, 1 University Circle, Horrabin Hall 8, Macomb, Illinois 61455
If you have any additional questions, please call the Office of Study Abroad & Outreach at (309) 298-1911. Western Illinois University complies with all federal and state nondiscrimination laws, orders, and regulations. Western Illinois University is an Affirmative Action, Equal Opportunity institution and affirms its commitment in all programs and activities to nondiscrimination on the basis of race, sex, religion, age, sexual orientation, marital status, disability, national origin, and status as a disabled veteran or Vietnam Era veteran.
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WIU Outreach Summer Camp Application