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Create Initiative Application -
Program Dates 6/24 - 8/2 | 9:00 a.m. - 2:00 p.m. | 1406 Laurens Street Baltimore MD 21217
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CETAT
Parent(s) / Guardian(s) Name
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Cell Phone (parent / guardian)
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Email Address (parent / guardian)
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Participants First Name
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Participants Middle Name
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Participants Last Name
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Street Address
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City
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State
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Zip Code
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Date of Birth
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Name & Address of Last School Attended
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Technology Interests (Check all that apply)
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Photography
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Computer Programming
Music
Drones
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How did you hear about the program?
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