Intermediate School STEM Program Application
Please complete a separate form for each child. Space is limited to 20 students, so applications will be time stamped for use in determining acceptance into the program.
Student's First Name
Your answer
Student's Last Name
Your answer
Teacher's Name
Your answer
Name of Parent or Guardian
Your answer
Parent/Guardian's Email
Your answer
Parent/Guardian's phone number
Your answer
Areas of student interest
Mark each statement below to verify that your child is eligible for participation
Submit
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