Appeal Form

Howdy Ags,

Thank you for taking time out of your day to complete Howdy Camp 2018's Membership Registration. We understand that you have provided some of the information requested by this webfrom in paper copy. This information will provide Aggie Transition Camps with an electronic copy that will make camp preparations and communication with Trinity Pines much more efficient. Once again, we thank you for both your time and commitment to the Mission & Values of ATC.

If you are unable to answer certain questions in this form, please type "N/A" in the field. As always, we are here to assist you with questions or concerns you may have - contact our Director of Administration & Risk Management Alex Bregenzer at [email protected].

Thanks & Gig 'em,

Director Staff 2017-2018
General Information
Name * Required
First Last
Prefered Name * Required
Name you would like on your nametag.
Sex * Required
- Female
- Male
Date of Birth
Month
Day
Year
Over Eighteen * Required
- Yes
- No
UIN * Required
Hometown * Required
Classification * Required
- Freshman (U1)
- Sophomore (U2)
- Junior (U3)
- Senior (U4+)
- Graduate Student
College of Major * Required
Major * Required
What will your major be in the coming semester?
Contact Information
Cell Phone * Required
Home Phone
Personal Email * Required
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Emergency Contact Name * Required
Emergency Contact Phone * Required
Camp Information
Camp Name * Required
Position * Required
- Counselor
- Chair
- Director
Shirt Size * Required
- Small
- Medium
- Large
- X-Large
- XX-Large
Personal Information
Family Physician Name * Required
Family Physician Phone * Required
Health Insurance Provider * Required
Health Insurance Policy Number * Required
Health Insurance Phone * Required
Allergies * Required
List any allergies to drugs, food, insects, plants, etc.
Medical History * Required
- Diabetes
- Asthma
- Heart Disease
- Epilepsy
- High Blood Pressure
- None
If you have a history of any of the listed conditions, please check them.
Medication Needs * Required
List any prescription medications you are currently taking.
Optical Issues
- Glasses
- Contact Lenses
Check the boxes if you wear any of the listed items.
Other Illnesses or Issues * Required
Please list any other illnesses or issues you might be facing that relate to camp.
Special Services Required * Required
Please list any special services you may require due to an existing medical condition, physical disability, or any physical condition limition your activities.
Dietary Restrictions * Required
Please identify if you have dietary restrictions, including, but not limited to, food allergies (even if listed above in allergies), religious observances, cultural requirements, etc.
Auto Information
If you do not have any of the below, please enter N/A
Driver's License Number * Required
Auto Insurance Provider * Required
Auto Insurance Policy Number * Required
Vehicle Make * Required
(Ford, Mazda, Chevy, GMC, Ferrari, Mercedes...)
Vehicle Model * Required
(F-150, Civic, Gallardo, Enzo...)
Vehicle Year: * Required
Vehicle Year * Required
Vehicle Color * Required
Licences Plate Number * Required

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Aggie Transition Camps

125 John J. Koldus Building
Mail Stop 1236
Texas A&M University
College Station, TX 77843-1236

P: 979.862.1785
F: 979.847.8854

Who we are

Aggie Transition Camps exist to successfully transition new students into the Aggie Family.

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