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Office of Special Programs

Application Form

Please submit this online form to
If you prefer, you may print this form and send completed copy to:

Kanet W. Thomas
Special Programs
Pepperdine University
24255 Pacific Coast Highway
Malibu, CA 90263-4264
Or fax to 310/506-4327

Contact Name:
Phone:
Organization:    Fax:
Address:
City: State:   Zip:
E-mail:
         (Preferred Method of Communication is e-mail.)

BOARDING NEEDS

 

Arrival
Date

First Meal
(Select one)

Departure
Date

Last  Meal
(Select one)

1st choice:

B L D

B L D
2nd choice:

B L D

B L D
3rd choice:

B L D

B L D

FACILITIES REQUESTED

Number of participants: Residents Commuters
Type of housing preferred: Dorms 2 Bedroom Apts
4 Bedroom Apts
Occupancy preferred: Single Double

Large Meeting Areas

Elkins Auditorium (seats 325) Smothers Theater (seats 450)*
Stauffer Chapel (seats 180) Fouch Amphitheater (seats 348)
Firestone Fieldhouse Gymnasium
(seats 2,656) 		 

Classrooms

Small Classrooms (seating 18-48) Number Needed
Large Classrooms (seating 49+) Number Needed

Athletic Facilities

swimming pool track/infield Alumni park
baseball field tennis courts gymnasium
Intramurals field basketball courts
Please list other specialized needs for facilities, food, housing, etc.: