Contact and School Information
ALL MATERIALS MUST BE SUBMITTED BY APRIL 26, 2026
Student Name
*
First Name
Last Name
Student Email
*
example@example.com
Student Birthdate
*
Student Gender
*
Female
Male
Other (please enter information below)
Other
Student Cell Phone Number
*
Please enter a valid phone number.
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School Currently Attending
*
I am currently in grade:
*
10 (sophomore)
11 (junior)
12 (senior)
Current GPA
*
T-Shirt Size
Mother's / Guardians Name
*
First Name
Last Name
Mother's / Guardian's Address (if different)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mother's / Guardian's Email
*
example@example.com
Mother's / Guardian's Cell Number
*
Please enter a valid phone number.
Father's / Guardian's Name
*
First Name
Last Name
Father's / Guardian's Address (if different)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Father's / Guardian's Email
*
example@example.com
Father's / Guardian's Cell Phone Number
*
Please enter a valid phone number.
Home Phone Number
Please enter a valid phone number.
About You
Educational Plans
*
Vocational / Professional Plans
*
Civic, church, community and volunteer activities
*
Employment experience (list jobs with a one-sentence description of duties)
*
About Your Education To-Date
Academic awards and honors
*
Sports participation
Other extra-curricular activities
*
Leadership positions
*
Academic major/ favorite courses of study
*
Very specifically, why do you want to attend LAB week?
*
Is there anything else you would like us to know about you?
Teacher / Guidance Counselor Evaluation
Important! Please provide us emails for your Teacher/ Guidance Counselor. They will receive a copy of your application to LAB and will be asked to submit and evaluation form along with a letter of recommendation. All materials must be submitted by April 26, 2024.
School Counselor's Name
*
First Name
Last Name
School Counselor's Email
*
example@example.com
Teacher's Name
*
First Name
Last Name
Teacher's Email
*
example@example.com
Thank You for Your LAB Week Application
Please click on the SUBMIT button if your application is complete.
Submit
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