SUNY Oswego Summer Intensive English Program (SIEP) Release Form

Name

PHOTOGRAPH RELEASE & CONSENT

I hereby irrevocably consent and authorize the State University of New York at Oswego to use and reproduce any photograph and any other like images of myself, for any purpose whatsoever, without any compensation to me. All such images shall solely constitute the property of the State University of New York at Oswego.*
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MEDICAL INSURANCE ACKNOWLEDGEMENT

ALL students in the Intensive English Program MUST have medical insurance. I understand that I am required to have medical insurance. The cost is $151.44 (3-week program), $302.88 (6-week program). This cost has been included in the overall program fee.


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Date/Time

ROOMMATE REQUEST


DIETARY RESTRICTIONS

Do You Have Any Health Related Dietary Restrictions? (Food Allergy etc.)*
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