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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