REGENERATION- Re-Crafting Green Science (Jan 2021) Thur, Jan 28 - Mar 4, 2021; 4:30 pm - 6 pm
**This class meets once a week on Thursdays for six weeks.**
PLEASE READ! This application is for participation in an upcoming STEAM Mentoring Program, for girls in under-represented groups age 10 -17. All sessions are held over Zoom, or will involve some days of asynchronous activities.

**Syllabus will be provided to all students, parents will receive a copy in email. Mentees are responsible for making up any missed assignments/projects. This is considered a college-prep level responsibility.
Participant Name *
Participant Name (2nd student, same household)
City/State *
Participant's Grade/Age *
Does your child have an email address? If yes, enter below. *
Is your student eligible for free lunch or public aid/assistance? (This information is used for demographics only and is confidential)
Clear selection
Parent's Name *
Parent's Email *
Parent's Phone
Check all that applies for participant *
Required
How willing and available are you (parent/grandparent/guardian) to be an active participant in this program with your student? (1 is low willingness or availability, 5 high willingness or availability) *
Why is a program like MSKSI STEAM Mentoring important for your student? *
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