Team 5843 Member Application
Student First Name *
Student Last Name *
Student Email Address *
Student Phone Number *
Parent First Name *
Parent Last Name *
Parent Email Address *
Parent Phone Number *
What school do you currently attend? *
Year you graduate High School? *
Student T-shirt size *
Do you have any food allergies/intolerances, latex allergies, asthma, medications, or other medical issues the Mentors would need to be aware of? *
Please list allergies and/or medical concerns if you answered Yes to the preceding question
Participation on the team requires a significant time commitment from January through April. List other activities that may impact your involvement on the team.
Why are you interested in the robotics team? What do you wish to achieve? (New students)
List the experience or skills you possess? (New students)
What field do you wish to pursue & why? (All Students)
What skills have you acquired or learned in the previous year(s)? (Returning students)
Did you achieve your goals from last year? If YES, what was it? If NO, what are you going to do differently? How could your Mentor(s) have helped? (Returning students)
Anything else you would like to share with the Mentors?
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