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  • 2021-2022

    Innovation Boulevard

    Afterschool Registration 

    Health & Science Innovations

     

  • Innovation Boulevard(iBLVD) is an afterschool program provided by Health and Science Innovations, Inc. and MSDLT at Belzer or Fall Creek Valley Middle Schools.

    To register, parents/guardians must complete this form. If you are registering more than one participant, please submit a separate form per child. The registration has to be filled in one session. 

    Please complete every section of this registration! Spots are available on a first-come-first-served basis.

     

     

     

     

  • Requirements

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    The minimum required attendace for Innovation Boulevard Afterschool is 65 out of 130 days of programming. This allows flexiblibity for participants who need it or who also participate in other concurrent extracurricular activities (sports, clubs, etc.).

     

  • Participant's Information:

  • Demographics

    HSI values diversity and equity in STEM fields. To that end, we seek to ensure diversity in our programs. Collecting demographic data from our participants helps us evaluate our success in this objective. Responses will not affect entrance to the program.



  • Parent / Guardian Information:

  • Logistics Information:


  • Interests and Goals:

    We would like to start getting to know your child and their interests before we start the program. Please fill this out with your child. Their input will also help us better serve them.
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  • Signature Conditions

    By signing below, I attest that all information included in this application is complete and correct. 

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  • Health and Science Innovations, Inc.

    2060 N. Shadeland Ave., Suite 110 | Indianapolis, IN 46219

    Ph: (317) 703-7836 | contact@scienceinnovations.org

    www.scienceinnovations.org

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