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Contact

Office of Summer Programs

30 Belmont Avenue
Smith College
Northampton MA 01063
Phone: 413-585-4455
Fax: 413-585-4344
Email: summerprecollege@smith.edu

Name of Student

Full Name (First, MI, Last)

Billing Information (all fields required)

First Name
Last Name
Street Address
Street Address 2 (if applicable)
City
State
Zip or Postal Code
Country
Phone
E-mail

Payment Information

  Full payment of all program fees is due by May 15, 2018.
   
I am paying for the following
(Please check all that apply)		 (includes $1000 nonrefundable deposit)

(includes $500 nonrefundable deposit)

(includes $500 nonrefundable deposit)

(includes $500 nonrefundable deposit)

(includes $300 nonrefundable deposit)


Alternately if you need to make partial payments




(2 week programs)

(if deposit already paid)

(if deposit already paid)

(if deposit already paid)

(if deposit already paid)

(if deposit already paid)

Pay an alternate amount $ .00 (whole dollar amounts only)