STEAM Summer 2021 Registration Form

STEM Initiative Registration

For the 3rd year in a row, we are excited to offer the STEM Initiative, a 2-week summer camp dedicated to empowering the next generation of innovators in the Bay Area. This experience is offered free of charge, at no cost to the student..
Hayward: 157 Smalley Ave., Hayward, CA 94541; Fremont: 43475 Ellsworth Street, Fremont CA 94539

Camp Date: 6/24 - 7/26, no class on 7/4; Camp Hour: 9:00 -3:00 pm, Mon - Fri
Please select your location?*
Please select a session your student would like to attend. Limit one session per student.*

Session 1: 6/24 - 7/5 (7/4 off)session 2: 7/8 - 7/19session 3: 7/22 - 7/26
Will you want to be informed for the available spot in other session.*
How do you know us?*
Student General Information
Please select your child's incoming grade level?*
School District?*
School Name?*
Student Full Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*
Meal Preferance?*
Camp Shirt?*
Parents (guardians) General Information
Mother Full Name*

First NameLast Name
Mother Email Address*

Confirmation Emailexample@example.com
Mother Phone Number*

Area CodePhone Number
Father Full Name*

First NameLast Name
Father Email Address*

Confirmation Emailexample@example.com
Father Phone Number*

Area CodePhone Number
Your support keeps our gears going!! As a nonprofit program, it would not be possible without the continued generosity and financial/material support. We would greatly appreciate financial contributions of any amount.

donate $15 for a camp shirtdonate $20 for a field tripdonate $30 for camp materialOther
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STEM Initiative Registration

Hayward: 157 Smalley Ave., Hayward, CA 94541; Fremont: 43475 Ellsworth Street, Fremont CA 94539

Student General Information

Parents (guardians) General Information