The Governor’s School of New Jersey at Drew University
The School of the Sciences
Madison, New Jersey 07940-4037
2016 New Jersey Governor’s School in the Sciences
FAMILY CHECKLIST
The following items/forms must be completed and returned, postmarked NO
later than May 28, 2016.
Please check the items you are returning and include this checklist with your
packet.
Name of Scholar (Please PRINT) _________________________________

Academic Background Survey

Course Selection and Housing Information Form

Health Care Authorization Form

General Health Form

Copy of the FRONT and BACK of your insurance card

I do NOT have health insurance. **Indicate this clearly on the General
Health Form**

Network User Agreement

Photography and Video Release Form

Declaration Against Plagiarism

Valuables Release Form