Black Hills Natural Sciences Field Station
Registration Form
Applicant Information:
 
Name:
   
First   MI   Last
Gender:  Male     Female    
School:
Address: 
  City: State:  Zip:
  Country: Birthdate:
Phone #:
Daytime Evening Fax
Email:
Current
Status
Graduate Junior Freshman
Senior Sophomore Special
Other
In case of emergency contact:
 
Name:
Phone #:
 
Daytime Evening  
Physical disabilities, allergies, and diet restrictions. 
 
How did you hear about this camp/course?
 
PAYMENT POLICY: Deposit must be received with your application or before deadline. Full payment is due two weeks before course / camp begins. Send check along with the application to:

Black Hills Natural Sciences Field Station
SDSM&T
501 E. Saint Joseph
Street Rapid City, SD 57701

CANCELLATION/REFUND POLICY: All deposits are non-refundable upon acceptance. BHNSFS reserves the right to cancel classes with low enrollment. In the event of low enrollment cancellation, you will be contacted and your deposit will be refunded in full.

Deposit included is $.