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Well Rounded Child After School STEM Camps
PLEASE COMPLETE THIS FORM IN ITS ENTIRETY OR RISK YOUR CHILD NOT BEING SELECTED. This form must be submitted by OCTOBER 3, 2018. Space is limited. Participants will be selected in the order which applications are received. Camps funded by Title IV and are free to students. TRANSPORTATION WILL NOT BE PROVIDED.
Child's First Name *
Your answer
Child's Last Name *
Your answer
Grade *
Home Room Teacher
Your answer
Military Connected *
Parent #1 Name *
Your answer
Parent #2 Name
Your answer
Home Address *
Your answer
Zip Code *
Your answer
Email Address
Your answer
Phone Number *
Your answer
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