New Student Application Form 2024-2025

Section 2: Contact Information

** Parent and Student email address is required
Relationship to Student *
Legal Guardian Name*

First NameLast Name
Parent/Guardian Cell Phone*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Student Email*
example@example.com
Section 3: Emergency Contact Information
Name*

First NameLast Name
Cell Phone Number*
Please enter a valid phone number.
Relationship to Student*
*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.
Parent Signature*

Clear
Student Signature*

Clear

2024-2025 STEP Student Authorized for Disclosure of Educational Information

This page must be completed in full in order to be eligible for STEP Program acceptance
Student Name*

First NameLast Name
School Name*
Grade Level*

7th8th9th10th11th12th
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

-          Other

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.
Parent Signature*

Clear

2024-2025 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.
Parent Signature

Clear
Student Signature

Clear

Required Document(s)

In order for your scholars application to be complete, we will need a copy of your scholars most recent report card (marking periods 1,2,3,4). Please upload the report card in the link below.
Report Card Upload*

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Should be Empty:

2024-2025 Student Application Form