2024 Sister to Sister International, Inc. STEAM Camp Online Application
Please fill out all requested information in this application to the best of your ability.
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Email *
A Completed Application Package Requires:
-A completed application form (below);

-A copy of your most recent report card or transcript;

-An interview may be required prior to admission.
CRITERIA
*STEAM Camp applicants should be Black or girls of color who reside or attend schools in Westchester County and will be in the 7th - 12th grades next school year. Parent/guardians are responsible for student transportation to and from the academy host site when meeting in-person.
APPLICATIONS ARE DUE BY MONDAY, JUNE 3RD!
STUDENT INFORMATION
Student's Full Name *
Age *
Date of Birth *
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Ethnicity *
Address *
Apartment
City *
Zip Code *
Student's Email Address
Student's Cell Phone Number (if applicable)
Home Phone Number (if applicable)
Grade (Fall 2023) *
Name of School *
Average Grade in Math
Average Grade in Science
What math and science course are you taking next year? *
What is your T-shirt size? *
Do you have any food allergies or dietary restrictions or allergies? *
If so, what are they?
PARENT/GUARDIAN INFORMATION
Parent/Guardian's Name *
Parent/Guardian's Phone Number *
Parent/Guardian's Email Address *
Preferred Method of Contact *
Required
DOCUMENT(S) SUBMISSION
Will you upload or email a copy of your most recent transcript or report card? *
MEDICAL AND MEDIA CONSENT
Is your child on any medication and/or do they have any medical condition(s) that program staff should be aware of for their safety and well-being?
 *
If so, what medication and/or medical condition?
Does your child have medical coverage?
 *
If yes, who is the Provider?
Medical Emergency:

I consent, in the event of medical emergency, to my child being given medical attention and, if necessary, medical treatment at a local healthcare facility. I understand that I will be responsible for the costs of any care provided to my child.

Initial
Liability Clause:
I understand that STSI shall not be responsible or legally liable for any bodily injuries or the result(s) thereof incurred and suffered by my child on any property of Sister to Sister International, Inc. or while engaged in any of its activities away from the program unless such injuries result directly from gross negligence or willful act of any member of STSI acting within the scope of their duties. I understand that this constitutes a release of STSI from liability relating to such loss or injury and a waiver of our right to bring legal action related to such loss or injury.
Initial
Promotional Release:
I understand that certain program events may include the media or other promotional activities and, as such, I consent to the use of photographs, videotaping, or quotes from my child being used as part of their participation for publicity, brochures, or other promotions.
Initial
Current Information:
I understand it is my responsibility to inform program staff of any changes in the information provided in this application.
Initial
ELECTRONIC SIGNATURE
Electronic Signature Agreement
By selecting the "Submit" button, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement. By selecting "Submit" using any device, means, or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature, and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting agreement between you and Sister to Sister International, Inc. You are also confirming that you, as the parent/guardian, are authorizing the student to enter into this Agreement.
Full Name of Parent/Guardian *
Today's Date *
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E-Signature of Parent/Guardian (Typed) *
Questions, please call: 646.683.0285 or email us at stsionthemove@gmail.com.
A copy of your responses will be emailed to the address you provided.
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