STEM -High-School Fall 2021 Opportunities

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 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 enter your School Name *

Student ID OSIS# *

Osis # can be located in the back of your student ID card

Indicate the Student's Current Grade - High-School Students ONLY *

9 10 11 12

Which Program would you like to Register? *

Saturday - Online ONLY In person AP Classes ONLY - Saturdays Sign me up for Both Programs!

Which Saturday Class would you like to Register? 10:00 AM - 1:00 PM *

Algebra I Geometry General Chemistry Living Environment

⭐️Available Courses:⭐️

Saturdays AP Courses
Tentative schedules 10:00 AM - 3:00 PM

Students can take up to 2 classes on Saturdays as classes are 80 minutes. Classes are held in person at the George Washington Educational Campus.

📍549 Audubon Avenue, New York, NY 10040

Classes are open to all DOE Public school students and will be in person at the GWEC. Saturday class times can slightly change but will remain in the 10:00 AM - 3:00 PM time frame.

Please indicate Which Class you want to register for?

AP Calculus AP Statistics AP Biology General Physics

Would you like to register for 2 classes? *

Yes No

Please indicate Which 2nd Class you want to register for? *

AP Calculus AP Statistics

Please indicate Which 2nd Class you want to register for? *

AP Biology General Physics

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 HIGH-SCHOOL STUDENTS! 🚨