STEM Summer Camp Registration Form

June 17 - June 21, 2013

* Indicates a required field

 
* Student's Name
* Student's Address
* City
* State
* Zip Code
* Expected Graduation Year
* Current Status
* Parent/Guardian Name+
* Parent/Guardian Email
* Parent/Guardian Phone
* Track interested in:
What Math classes have you completed?
What Science classes have you completed?
* Have you attended a STEM camp in the past?
If so, where?
What subject areas did you cover?
* Does your School have a STEM Program?

Emergency Contact
* Name
* Relationship


Cost: $25.00 (You will be contacted by our Finance Department to process payment)

+Mandatory Parent meeting on June 17, 2013 from 8:30 a.m. until 9:00 a.m


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