MITY ExplorSchool Application

Application For Middle School Program: Summer 2025

Students must be entering grades 6 - 8 in the fall. Applications will not be reviewed until all required materials, including a tuition deposit or financial aid application, are received.
Student's Name*

First NameLast Name
Preferred Name (If Different)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student's Email
example@example.com
Student's Cell Number
Please enter a valid phone number.
Gender Assigned At Birth*
Pronouns Used*
He/Him/His, Her/Her/Hers, They/Them/Theirs, Etc.
Date Of Birth*

MonthDayYear
Current School*
Current Grade Level*
Was The Student Accepted To A MITY Program in 2024?*
Would You Like Your Information To Be Included On The Carpool List?*
Student's T-Shirt Size*

Parent / Guardian Information
Parent/Guardian 1 Name*

First NameLast Name
Parent/Guardian 1 Email*
example@example.com
Parent/Guardian 1 Cell Number*
Please enter a valid phone number.
Parent/Guardian 2 Name

First NameLast Name
Parent/Guardian 2 Email
example@example.com
Parent/Guardian 2 Cell Number
Please enter a valid phone number.
How Did You Learn About MITY?*

Course Selection

Please select your 1st and 2nd choice class for each period/session you want to attend. Leave the rest blank. When a class becomes full, it is labeled "Waitlist". If your first choice class is full, we will enroll you in your second choice and put you on the waitlist for your first choice.
Which session(s) are you applying for?*
Session A: June 16 - 27, 2025 at Saint Thomas Academy
Will you be attending full day or half day?
1st Choice Class: Morning
2nd Choice Class: Morning
1st Choice Class: Afternoon
2nd Choice Class: Afternoon
Does the student need extended care? Note: Preregistration is required. Drop-in care is NOT available.
Session B: July 7 - 18, 2025 at Benilde-St. Margaret's
Will you be attending full day or half day?
1st Choice Class: Morning
2nd Choice Class: Morning
1st Choice Class: Afternoon
2nd Choice Class: Afternoon
Does the student need extended care? Note: Preregistration is required. Drop-in care is NOT available.
Once you submit the application you cannot go back. If you have any questions or wish to make changes to your application, please contact the MITY office at 651-243-2221 or info@mity.org.

Materials Submission

All students must submit a current transcript. Students who were not accepted to ExplorSchool in 2024 must also submit a teacher recommendation form and a paragraph explaining why you wish to attend MITY and the specific courses selected.
All Students: Upload current transcript / report card here or email it to: info@mity.org

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New Students: Upload paragraph here or email it to: info@mity.org

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Health Information
Emergency Contact (Must be different than parent(s) / guardians(s) listed above)*

First NameLast Name
Emergency Contact Cell*
Please enter a valid phone number.
Are all immunizations current?*
If the student has been diagnosed with ADHD, anxiety, asthma, depression, diabetes, severe allergies, or anything else that the MITY staff should know about, please explain.
If the student has any specific needs or accommodations for behavioral, physical, emotional and/or educational challenges, please explain.
List any activities that are limited by the student's physician.
List any prescription medications the student is taking, including dosage. Indicate the use of Epipen or Inhaler. Note: MITY staff cannot distribute prescription medications to students with the exception of an Epipen.
Student may be given the following if needed:*

IbuprofenTylenolBenadrylNone
Insurance Company*
Policy Number*
Group Number

Consent Authorization

Typing your name on this form is considered your signature.
Authorization for Medical Care

The health information provided above is correct so far as I know. The person herein described has permission to engage in all activities except as noted. I hereby give permission to the Adult-In-Charge to provide routine health care. I consent for my child to receive such medical treatment and/or surgical procedures as are deemed necessary in the event of an emergency and to assume liability for any medical expenses involved. This authorization extends to my child’s participation in any activity sponsored by MITY. Should a medical emergency arise during my child’s participation in a MITY-sponsored activity, I understand that reasonable efforts will be made to contact me or my designated alternate at the phone numbers I have given. If it is believed my child’s life or health may be adversely affected by the delay that an attempt to contact me or my designated alternate would cause, I consent to the administration of medical treatment and/or surgical procedure deemed necessary by the medical doctor and/or medical facility and the immediate administration of life-sustaining measures deemed necessary under the circumstances.

Field Trip Permission

The student named above has my consent to take supervised field trips with MITY staff. I understand that necessary planning and precautions will be taken, and will not hold MITY or those supervising the trip liable for accidents or injuries associated with my student's participation.

Photo Release

I authorize Minnesota Institute for Talented Youth to use any photos or video of my student for presentations, advertising, publicity and promotion. MITY will never use a student's name.

Cancellation Policy

I have read and understand MITY's Cancellation Policy:

All applications must include a deposit of $300 or a completed financial aid application. $100 of the deposit is non-refundable.
- After April 1, the full deposit of $300 is non-refundable.
- The balance is due by May 1. After May 15, there is no refund of tuition.
- If MITY cancels a course before it begins, students will be placed into their second-choice class.
- Refunds are not provided once a session begins.
- In the unlikely event that MITY terminates a course during the session, MITY will consider the circumstances and may, at its sole discretion, issue a partial refund or credit.
Code of Conduct

By signing below, I acknowledge that both the student named above and myself, as their parent or legal guardian, have read and agree to abide by the MITY Code of Conduct. I understand that violations of these rules or any other inappropriate conduct may result in discipline, including dismissal from the program. Students who are asked to leave the program for discipline issues will not receive a tuition refund.
Parent/Guardian Signature*

First NameLast Name
Today's Date*

MonthDayYear

Submit Deposit

A tuition deposit - or a completed financial aid application - is required in order for an application to be reviewed. Families will receive a full refund if a student is not admitted. NOTE: If you are applying for financial aid, please leave this section blank.
Please select the quantity of each item from the dropdown menu before hitting submit. If you only check the box, payment will not go through. You do not need to submit a deposit if you are applying for financial aid.
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Summer 2025 DepositA deposit is required for EACH SESSION you wish to attend UNLESS you are applying for financial aid. (FA students are not required to pay a deposit.)
$300.00 Quantity

Optional DonationMITY relies on donations and grants to provide financial assistance to students in need. 100% of your donation goes to scholarships.
$10.00 Quantity

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

Application For Middle School Program: Summer 2025

Parent / Guardian Information

Course Selection

Session A: June 16 - 27, 2025 at Saint Thomas Academy

Session B: July 7 - 18, 2025 at Benilde-St. Margaret's

Materials Submission

Health Information

Consent Authorization

Submit Deposit