STEM -Middle School Fall 2021 Opportunities

OPEN REGISTRATION FOR MIDDLE SCHOOL STUDENTS! 🚨

Registration Deadline September 15, 2021
Student Information
Student's Name *

First Name Last Name
Personal Email *
Phone Number *

Area Code Phone Number
Home Address *

Street Address

Apt #

City State / Province

Postal / Zip Code
Birth Date *

Month Day Year
Gender *

Male Female Other No Response
Ethnicity *

Black Non-Hispanic Hispanic White Non-Hispanic Native American Asian-Pacific Islander
Primary Language *

English Spanish
Have you Attended a STEM Institute Program recently? *

Yes No
If Yes, Which program did you last attend? *

SHSAT Prep Program Regents Prep Program Saturday Program Summer Bridge Summer Institute Other N/A
Do you attend a NYC DOE Public School? *

Yes No
Select Your School Name *
If Other not Listed Name *
Indicate your School Name
Student ID OSIS# *
Osis # can be located in the back of your student ID card
Indicate the Student's Current Grade - Middle School Students ONLY *

6 7 8
⭐️Available Courses:⭐️

Monday & Wednesday or Tuesday & Thursday
ONLINE 4:00 PM - 6:00 PM

Students can take up to 2 classes on a Monday - Thursday Schedule.
Please indicate Which Class you want to register for?

Civics Engagement - Mon & Wednesdays Financial Management- Mon & Wed Architecture -Tue & Th Coding Fundamentals - Tue & Th
Would you like to register for 2 classes? *

Yes No
Please indicate Which 2nd Class you want to register for? *

Civics Engagement - Mon & Wednesdays Financial Management- Mon & Wed
Please indicate Which 2nd Class you want to register for? *

Architecture -Tue & Th Coding Fundamentals - Tue & Th
Parent/Guardian Information Must be Filled out by Parent or Guardian
Name *

First Name Last Name
Cell Number *

Area Code Phone Number
Parent Email *
How did you hear about us? *

School Friend Social Media Flyer Internet
Media Release and Authorization

I hereby consent for my child to participate in interviews, the take of photographs and videos for educational purposes. I also grant the STEM Institute, the right to edit, use and reuse such products for non-profit purposes including use in print, on the internet and all other forms of media. I also hereby release the New York City Department of Education and its agents and employees from all claims, demands and liabilities whatsoever in connection with the above.
Parents Initials *
If consenting to the Media Release form please place your initials
Parental Permission

I hereby give my approval for my child’s participation in any and all activities prepared by the STEM Institute during enrollment of the program.

One High School elective credit will be granted upon successful completion of each course for students attending an NYC DOE Public School, via our shared instruction Partner Inwood Early College.

Students who are accepted at the Stem Institute MUST have their camera ON at all times while in classes.

Students require a 65%> or above in order to receive a successful passing grade.

Students who receive under 64% will earn an NC or F letter grade reported to their home school.
Submit a Picture of the Student *
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OPEN REGISTRATION FOR MIDDLE SCHOOL STUDENTS! 🚨