Explorers Program Application 2017
Please complete all sections. Deadline: Monday, May 8, 2017
Checklist
Verify that all areas of your application are complete. Deadline: May 8, 2016.
Application Checklist
Required
Teacher Recommendation
Two (2) teacher recommendations must be submitted. Share this link with your teachers: https://form.jotform.com/explorersprogram/teacher-recommendation-form
Incomplete applications will not be reviewed.
Upload Report Card & Resume
Please click on the link and upload files: https://form.jotform.com/explorersprogram/student-files
Application
Please complete all application questions. You are welcome to submit the application first and then upload the supplemental materials. Just be sure to save the links listed above. All materials must be received by Monday, May 8, 2017.
Please select one:
Last Name
Your answer
First Name
Your answer
M.I
Your answer
Date of Birth
Your answer
Age
Your answer
Home Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Email
Your answer
School
Your answer
Current Grade
Your answer
Grade in 2017 - 18
Your answer
School District
Ethnicity
Your answer
Country of Birth
Your answer
Are you a U.S Citizen?
If you answered no, how long have you lived in the United States?
Your answer
What language(s), other than English is spoken in your home?
Your answer
How did you hear about the program?
Parent/Guardian Information
Please complete all sections. If a section does not apply to you please fill in N/A.
Mother
Last Name
Your answer
First Name
Your answer
Home Address
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Email
Your answer
Father
Last Name
Your answer
First Name
Your answer
Home Address
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Email
Your answer
Parental Guardian
Last Name
Your answer
First Name
Your answer
Home Address
Your answer
Cell Phone
Your answer
Email
Your answer
City
Your answer
State
Your answer
Zip code
Your answer
Home Phone
Your answer
Essay
Write a short essay on one of the following topics:
Future professional aspiration or design your perfect teen night. Minimum 250 words
Your answer
Short Response Questions
Why do you want to join the Explorers Program? (min. 100 words)
Your answer
Please list all organizations and/or clubs of which you are a member of. Include your position within the club and year(s) you have been involved.
Your answer
Are you able to commit to 4-6 hours per week to the Explorers Program?
Are you available for work on weekends?
Please check off the topics that interest you. (Check as many as applicable)
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms