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Florida Zero Robotics Application 2017 Middle School Summer Program
COMPLETED APPLICATIONS MUST BE RECEIVED BY MONDAY, APRIL 17th 2017
Questions may be addressed to: awalker@amfcse.org

ELIGIBILITY:
- Any public or private school or community-based organization that serves middle school youth.
- Program must serve a team of 10-20 youth for a minimum of 15 hours per week for 5 weeks.
- Program must have computers and internet access.
- Priority consideration will be given to programs who will target under-represented or under-served populations.

ADDITIONAL INFORMATION IS AVAILABLE AT: http://zerorobotics.mit.edu/tournaments/26/info/146/0/
Florida will participate in the SESSION 2 program

PLEASE SEE BOTTOM OF FORM FOR ADDITIONAL REQUIRED COMMITMENTS.

Email address
Program Information
Program Name
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Address Line 1
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Address Line 2
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City
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Zip
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Phone
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Fax
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Program Type
(check all that apply)
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Twitter
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Facebook
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Instagram
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Website
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Contact Information
Team Leader (This person will coordinate the Zero Robotics program at this site and serve as the main point of contact.)
Name
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Phone
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Email
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Executive Director/Principal.
Name
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Phone
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Email
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Demographic Information
Indicate the percentage of students who fit the following demographics in your program.
Male
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Female
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Low Income (receive free/reduced lunch and/or contracts/vouchers/subsidies)
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Youth with diagnosed disabilities
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English language learners
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From low performing districts
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American Indian or Alaskan Native
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Asian
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Black
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White
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Other
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Hispanic Origin
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Indicate, from the above demographics, the students that you will specifically target for participation in Zero Robotics and how you will do so.
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Experience
(Please note that experience with STEM/coding is not required and will not impact your ability to participate.)
Does your program currently offer a STEM course and/or curriculum during the summer?
IF YES, describe your STEM offerings, any online or printed STEM curricula you have used, and how Zero Robotics will complement your summer program.
Your answer
IF NO, explain why you would like to add a STEM component to your summer program through Zero Robotics and how you will do so.
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Please describe the level of experience (if any) that your team leader, staff, volunteers, mentors, etc. have with coding.
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Support and Partnerships
Which agencies, organizations, or other partners do you plan to collaborate with on this project. Do you have a commitment from these partners? If so, have they agreed to provide financial or in-kind support? If you have not yet engaged partners, explain your plan to do so.
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We host three in-person events: an educator training, field day, and finals competition. Please describe your plan to facilitate travel for educators/students to these events.
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Commitment
Please indicate that your site agrees to the program commitments by checking the following boxes:
Required
Electronic Signature
Please type your full name below, by doing so you agree that all of the information provided on this form is correct
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