Student Application - Hybrid EMPOWER
Engaging Multidisciplinary Professional Opportunities for Women in Environmental Research
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Email *
How old are you?
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Student Name *
First, M.I., Last
Do you have access to a laptop, desktop computer or iPad? *
Do you have reliable access to internet? *
Are you able to attend in-person and virtual sessions all 4 weeks? (Note: Camp runs from June 6-July 1)
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What is your address? *
What city do you live in? *
What state do you live in? *
What is your zip code? *
What is your phone number? *
Please include area code.
What school do you currently attend? *
What grade will you be entering for the 2021-2022 school year? *
Required
Science Courses Taken
Select all that apply.
Biology
Chemistry
Physics
Anatomy
Other Science
General
Honors
AP
IB
If "Other Science", which science was taken?
T-Shirt Size *
Parent/Guardian Name *
First Last
Relationship to Student *
Parent's Phone Number and Email Address *
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