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AESA STEM Academy ARMATH STEM Program Pre-Registration
Please complete the form below to reserve your child's spot in our program.
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* Indicates required question
Student's First Name
*
Your answer
Student's Last Name
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Your answer
Email Address
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Your answer
Mobile Telephone Number
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Your answer
Address
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Your answer
City, State, Zip
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Your answer
Student's Grade Level
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Your answer
Student's School Name
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Your answer
Student's interest in Science, Technology, Engineering and Mathematics (with 5 being highly interested in STEM)
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Choose
1
2
3
4
5
Has your student participated in any STEM program outside of his/her school?
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Yes
No
If your child is a previous/current student of ours, which class was he/she attending?
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Saturday 9am - 1pm
Saturday 1pm - 5pm
Sunday 9am - 1pm
Where did you hear about our program?
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Choose
Current/Previous Student
Instagram
Facebook
Radio
Referral
Would you be interested in finding out about our low income program for discounted class fees?
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Yes
No
Maybe
Does your child have any food allergies? If so, please explain.
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Your answer
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