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Experience STEM at MassBay - Summer Program for Middle School Students Form
Experience STEM at MassBay Application Form

Dates: July 6-17, 2015
Drop Off Time: 9.00 AM
Pick Up Time: 3.30PM Participants must be picked up at the latest by 3.30PM. (No exceptions).

Drop-off/Pick up Location:
Cafeteria
MassBay Community College
50 Oakland Street, Wellesley Hills, MA 02481

The Summer program provides middle school students (Entering Grades 7 and 8) an engaging and hands on STEM experience, an exciting introduction to various STEM careers and will enable them to develop new skills. Students will work collaboratively to design and build a themed STEM hands-on project during the 10 days. Students will have the opportunity to work in our state-of-the art science and technology labs and learn to use math and science concepts to solve challenges.

Register now, as spaces are limited!

To Register:
Step 1. Complete this brief online application form. Please note that only parents/legal guardians of middle school students can complete the form for their children.
Step 2. Within 1 to 3 business days of filling out the online form you will be e-mailed the registration form and information regarding how to fill it out and where to send it. Then complete that form and a payment of $350.00 for each middle school student to be registered. Upon receipt, the child will be registered for the summer program.

We will contact you if we need further information from you, need to communicate about cancellations or if space is not available.

Refunds are no longer available at this time.

First Name *
First Name of the parent/legal guardian submitting this form
Your answer
Last Name *
Last Name of the parent/legal guardian submitting this form
Your answer
Street Address *
provide your street address - such as "50 Oakland Street"
Your answer
Apt #
Apt #, if any
Your answer
City/Town *
Your answer
Zip Code *
such as " 02481"
Your answer
Contact email *
Your answer
Contact Phone number *
Your answer
Emergency Contact Phone Number *
In case of emergencies, we will reach you at this number
Your answer
Emergency Contact Email *
Your answer
Child 1
First Name and Last Name of Child 1
Your answer
Grade entering in fall 2015 - Child 1
Your answer
School District Child 1
Your answer
Child 2
First Name and Last Name of Child 2
Your answer
Grade entering in fall 2015 - Child 2
Your answer
School District Child 2
School district of child #2 if different from Child 1
Your answer
Child 3
First Name and Last Name of Child 3
Your answer
Grade entering in fall 2015 - Child 3
Your answer
School District Child 3
School district of child #3 if different from Child 1
Your answer
Special Accommodations needed
Yes
No
Child 1
Child 2
Child 3
Please list what special accommodations might be needed for your children if an answer to the question above is "Yes".
Your answer
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