In order to be eligible for the STEP Program, the applicant must have been a resident of New York State at least 12 months prior to application and must be enrolled in grade 7-12 for the 2022/2023 academic year.
Section 1: Student Information
Per state mandate, additional documentation is required if you identify as Caucasian, Asian, or Pacific Islander
1. Verification of Family income (1040 Form)
2. Reduced or free Lunch Eligibility Paperwork (If applicable)
Section 2: Contact Information
** Parent and Student email address is required
Section 3: Emergency Contact Information
*To the Parents/Guardians: Your signature on this application signifies that all the information given in this application is accurate and complete to the best of your knowledge in accordance with Federal and State regulations.
2022-2023 STEP Student Authorized for Disclosure of Educational Information
This page must be completed in full in order to be eligible for STEP Program acceptance
I am the person legally responsible for the above named individual and I authorize the Science and Technology Entry Program to obtain information from (please indicate your school): blanks* and release information to Syracuse University Science and Technology Entry Program (STEP) 419 Sims Hall Syracuse, NY 13244
I hereby authorize the disclosure of educational information between the Science and Technology Entry Program (STEP) and the School district indicated above, in accordance with the Family Educational Rights and Privacy Act (FERPA).
Specific information to be released or obtained includes the following confidential information necessary for educational services:
- Student standardized test scores, Grades, and Report Card Information- New York State Student Identification System (NYSSIS) ID which is also known as the Student State ID.
- Attendance Data and Suspension Data
- Information on a Student’s Individual Education Plan (IEP)- Teacher/administration notes and correspondence
- Individual course communications, assignments, and interim results
This information is required for the purpose of any necessary and ongoing educational needs inclusive of evaluations and recommendations for further development.
By signing below I am stating that:
- I understand the information disclosed, as permitted by this authorization, will not be re-disclosed by the receiving entity (and/or its affiliates). I do understand that local, state, and federal laws do exist to protect the confidentiality of this information.
- I understand that I have the right to revoke and/or restrict this authorization at any time without penalty, provided that I submit a request in writing to the STEP Office.
- I authorize the periodic, on-going disclosure of the above information. This authorization expires one year after date of signing or at disenrollment from services, whichever comes first. Re-authorization will be obtained after one year if information is still needed.
2022-2023 Student Questionnaire
Be sure to respond to all questions on this page. Information below is required by the New York State Education Department which provides funding for the STEP Program.
2022-2023 Informed Consent Form
It is critical that the coordinators of the STEP program collect information from students who participate in activities in order to continuously improve the program and meet the needs of the students, as well as participate in focus group sessions to discuss the program.
Your signatures below indicates that you are willing to have your child participate in the STEP program information gathering efforts. Choosing not to sign this consent from will in no way influence your child’s ability to participate in the STEP program.
2022-2023 STEP Program Media Release
Press and Performance Release
I hereby give my permission to Syracuse University, its agents, successor, assigns and/or newspapers, radio, television or websites, statewide conferences to use my child’s photograph (whether still, motion or television) and recordings of my child’s voice, for publicity regarding the STEP Program.