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Summer Bridge Program Participation Form

Please complete the required information below. This information will be used to provide the best possible experience during the Summer Bridge Program! Submit no later than Friday, June 7, 2024.

Participant Information

First Name *

Last Name *

Columbia Email Address *

Alternate Email Address *

Cell Phone Number *

Example: XXX-XXX-XXXX

Date of Birth *

Year

Month

Day

School *

Columbia College

Columbia Engineering

Intended Major(s) *

If unsure, please enter "undecided."

Emergency Contact Information

Emergency Contact Name *

Relationship to Emergency Contact *

Emergency Contact Number *

Example: XXX-XXX-XXXX

Guest RSVP for Orientation

Depending on campus policies, we currently anticipate being able to accommodate a maximum of one guest per Summer Bridge participant for Orientation on July 9, but guests must be registered in advance and present email authorization upon arrival. Please note guests will be asked to depart once the dinner has ended.

Will you be bringing a guest with you to Orientation? *

Yes

What is your guest's full name? *

Example: John Smith

What is your guest's email address? *

Example: johndoe@gmail.com

Is your guest a minor? *

Yes

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Academic Success Programs

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403 Alfred Lerner Hall
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Call: (212) 854-3514

Fax: (212) 854-2458

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Monday–Friday
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http://www.cc-seas.columbia.edu/asp

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Summer Bridge Program Participation Form

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