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
Student's Last Name
Name of Parent or Guardian
Parent/Guardian's phone number
Areas of student interest
Mark each statement below to verify that your child is eligible for participation
My child is passing all academic subjects.
My child has positive classroom behavior and no office referrals this year.
My child works well independently and in groups.
I understand that images of my child may be included in digital highlights from this program.
I will arrange to have my child picked up from school by 4:15 on meeting days.
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This form was created inside of Mount Zion Community Unit District #3.
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