Application for St. Thomas Aquinas College Summer 2014 STEM Enrichment Program
This form is to be completed by the parent.
Child's First Name *
Your answer
Child's Last Name *
Your answer
Grade as of September 2014
Your answer
Parents'/Guardians' Full Name *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Home Phone *
Please enter your 10 digit number or write none.
Your answer
Cell Phone *
Please enter your 10 digit number or write none.
Your answer
Email Address *
Your answer
Emergency Contact (s) *
Please list name and phone number
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Name and phone number of person who will be picking up your child *
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Child's School *
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Reason for Applying *
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Health History *
Please include any allergies
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Cost: A non-refundable fee of $400 ($350 for early bird registration before April 15th) will be required with registration. Only a limited number of students can be accepted so parents are urged to apply as early as possible. Checks should be mailed directly to: Paula Hughes, School of Education, St. Thomas Aquinas College, 125 Route 340, Sparkill, NY 10976. Please put your child's name on the check.
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