SLIPP Student Regsitration Page

Please complete the form below to process your registration payment information. You will receive an email receipt for your transaction shortly after completing and submitting this form. Payment options are detailed below.
Freedoms Foundation at Valley Forge
P.O. Box 67
1601 Valley Forge Road
Valley Forge, PA 19481
Phone (610) 933-8825 Ext. 292

* = Required Field

*Student Name

*Gender

Female Male

*Area of Concentration

Legal Policy Environmental Policy Public Health Policy

*Parent/Guardian Name

*Address

*City

*State

*Zipcode

* Phone

( Example: xxx-xxx-xxxx )

*Email

*Confirm Email

Tuition & Payment Information

Tuition is $1,150 • Alumini Rate is $950
Includes tuition, room and board, field trips and program materials
A deposit of $250 is required. Complete payment due no later than 7/27/2012

Your online transaction is safe and secure.

Amount

Full Name

( As it appears on card )

Card Type

Card Number

Security Code

Expires Month

Year