2019 Worcester STEM Leadership Cohort Application
This application is to be used by all applicants who are currently in grades 9-11 (entering grades 10-12 in the 2019-2020 school year). The 2019 Worcester STEM Leadership Cohort will be held at University of Maryland Eastern Shore from 9 am-4 pm July 22-26, 2019. Transportation is provided.

Please be advised that there are three sections to this application and all three sections must be completed. Students will need to write a paragraph and will need to provide email addresses for two teacher references. After completing the full application, please mail a copy of your transcripts or most recent report card to Worcester County Economic Development, Worcester STEM Leadership Cohort, ATTN: Fawn Mete, 100 Pearl Street Ste B, Snow Hill, MD 21863. Alternatively, you could email a screenshot from Powerschool or a scanned copy of recent transcripts or a report card to fawn@sinepuxentgroup.com.

First Name *
Your answer
Last Name *
Your answer
Current Grade (2018-2019 school year) *
Are you a former camper with our Reach for the Stars STEM Camp program?
Student Cell Phone Number *
The STEM Leadership Cohort emphasizes personal responsibility and particpants will be accountable for their own communication regarding the program whenever possible. Parents will also be informed via email of important information.
Your answer
Student Email Address *
Applicants, please check your email regularly. This will be the primary means of communication regarding your application status and the program schedule.
Your answer
Parent/Guardian Names *
Your answer
Parent/Guardian Emergency Contact Cell Phones *
Your answer
Parent/Guardian Email Address
Your answer
Residential Address *
Used to determine eligibility and to plan the transportation route.
Your answer
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