Registration Form for Lamplighters and Summer STEM Programs
Indianapolis Uplift Foundation https://indyuplift.org
Student Name
*
First Name
Last Name
Student E-mail Address
Student Phone Number
-
Area Code
Phone Number
School Attended
Current Grade Level
Which program?
Lamplighters Mentoring Program
Summer STEM Program
Interests
Parents Name:
Parent's Email Address
example@example.com
Parent Phone Number
-
Area Code
Phone Number
SUBMIT
Should be Empty: