University of Virginia Library

RETURN THIS

If you expect to attend the Summer School, please fill out the form
below and forward it to the "Director of the Summer School, University,
Virginia." This will not bind you to attend.

1. Name. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. Address. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Present occupation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. Where Board and Room are Desired. . . . . . . . . . . . . . . . . . . . . . . . . .

5. What rate do you wish to pay per week for board. . . . . . . . . . . . .