Date of Birth (mm/dd/yyyy)*
Emergency Contact Name*
Relationship to Applicant*
Name of High School*
Why do you want to participate in the 2017 Summer Workshop?
What is one thing about you that might surprise us and why?
Why is studying the Holocaust important?
Dr. Richard Harker
Museum of History and Holocaust Education
Kennesaw State University
3333 Busbee Drive, MD 3308
Kennesaw, GA 30144
How did you learn about the Museum of History & Holocaust Education?
Applicant's Signature (By typing your name, you agree the information provided is accurate to the best of your knowledge.)*
Parent's Signature (By typing your name, you agree to allow your son/daughter to participate in the 2017 Summer Workshop, and that the information provided is accurate to the best of your knowledge.)*
Kennesaw State University, 3333 Busbee Drive, Kennesaw GA 30144
© 2014 Kennesaw State University. All rights reserved.
Hours: Monday - Friday; 10:00am - 5:00pm