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Name
I am applying as part of:*
We are accepting applications for SPRING 2023. The class runs from March 10 to March 26, 2022 Weekends are included we meet from 7:45 am to 5:30 pm for the spring session.
I am fully vaccinated and can provide documentation:*
As of April 2022, Vaccines are NOT currently required. However guidelines change and if COVID restrictions are re-instated, anyone who does not provide proof of vaccination will be dropped from this program.
My personal email address (NOT your K-12 school email address)*
A good phone number to reach you
The best number to use in case a text message is used in urgent situations.
MM slash DD slash YYYY
Parent or Legal Guardian*
What school do you attend?*

Grade*
I identify my gender as:

Describe all that apply, such as: Hispanic or Latino/a; Arab or Arab American; Native American or Aleut; Caucasian (non-Hispanic); Black or African American; Asian or Asian American; Pacific Islander; Native Hawaiian
Do you receive Special Education Services?
Are you interested in a Science Career?
This field is for validation purposes and should be left unchanged.