Science Discovery Camp Application
**This program is full. Please complete the application below to join our waiting list! You will be contacted via email i fa spot opens up.**

Please complete this online application for the 2017 Science Discovery Camp at the University of Maryland. Please note this is not a residential program.

Cost: $250/session- due upon acceptance to program not with registration

For questions, please email: oses@physics.umd.edu

Student Information
1. Student First Name:
Your answer
2. Student Last Name
Your answer
3. Street Address:
Your answer
4. City, State:
Your answer
5. Zip:
Your answer
6. What grade will the student be entering in fall 2017?
7. Birthday:
Example: December 15, 2012
Your answer
8. Gender:
Your answer
9. Student Lab Coat Size
School Information
Please provide information on the school attended this past school year (2016-2017).
10. School County:
Your answer
11. School Name:
Your answer
12. Name of Science Teacher (optional):
Your answer
Parent Information
13. Parent/ Guardian Name:
Your answer
14. Email Address:
Please provide the email address where you would like to receive all correspondence regarding the program.
Your answer
15. Cell/Home Phone Number
Your answer
16. How did you hear about the Science, Engineering, and Youth Summer Camp.
17. As the parent/guardian of the applicant, I agree to the application submission to the University of Maryland's Science, Engineering, and You Summer Camp. I understand that my child will attend the entire one-week program. I understand this is not a residential program and I will provide transportation to and from the campus each day through the duration of the program.
Student Personal Statement
Statement should be written by the student applicant. (One paragraph)
18. Why do you want to attend the Science, Engineering, and You Summer Camp?
Your answer
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