Hot Rod STEM 2018
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Child's Name (name they want to be called)
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Parent/Guardian Full Name(s)
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Permanent Mailing Address
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City
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Zip Code
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Day Time Phone Number (format 8641234567)
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Cell Phone Number (format 8641234567)
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Parent/Guardian E-mail Address
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My Child is a:
What school did your child attend during the 2017-18 school year?
In what grade will your child be enrolled during the 2018-19 school year?
Did your child attend Hot Rod STEM camp last summer?
If my child is selected to be a participant in the 2018 Hot Rod STEM summer camp: *
(Please indicate below that you have read and understand the following by checking the corresponding box.)
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If you would like for your child to be considered for a scholarship, please indicate which type.
If you will require financial assistance, please provide a brief explanation of your situation. ALL INFORMATION WILL REMAIN CONFIDENTIAL.
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