UAA Summer Engineering Academies 2025 Camp Registration Form

UAA Summer Engineering Academies 2025 Camp Registration Form

Application Deadline: March 1, 2025
Participant's Details
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Gender*

MaleFemaleN/A
Participant's Grade for 2025-2026 School Year*
School Name*
Does the participant qualify for FREE or REDUCED school lunch program?*

YesNo
Will you be requesting a waiver of the Academy fee?*

YesNo

Parent/Guardian's Details for Correspondence
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Mobile Phone*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Parent/Guardian Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code