UPS / SHADES OF BLUE Aerospace Camp
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Last Name *
First Name *
Address *
City *
State *
Zip code *
Home Phone # *
Cell Phone # *
Email Address *
Gender *
Date of Birth *
School Name *
Current GPA *
Have you participated in this program before? *
If Yes, how may years
Parent / Guardian first and last name *
Parent / Guardian phone number *
Emergency contact *
Emergency contact phone # *
Names of persons authorized to pick up students *
Important Medical information / health concerns / allergies
Emergency medical contact info
Special accommodations needed
Essay - Please tell us why you would like to attend the Aerospace Camp *
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