SITC STEM program registration form
Applicants can sign up year-round as enrollment is open and free to the student. Once applicantions are reviewed, parents and students will be notifed to come in for an interviews with SITC STEM team.
Student Name
*
First Name
Middle Name
Last Name
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
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31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
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2012
2011
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Year
Gender
*
Please Select
Male
Female
N/A
Address
*
Street Address
City
State / Province
Postal / Zip Code
Mobile Number
*
Format: (000) 000-0000.
Student E-mail
*
example@example.com
Are you a US Citizen?
*
Yes
No
What is your race?
*
Parent/Guardian Name
*
First Name
Middle Name
Last Name
Address
*
Street Address
City
State / Province
Postal / Zip Code
Parent/Guardian Number
*
Format: (000) 000-0000.
What is the name of your high school?
*
Street Address
City
State / Province
Postal / Zip Code
What grade is the student?
*
Are you available for a personal or phone interview with the selection committee?
*
Yes
No
Note to Students: Code of Conduct Students are expected to: 1. Show respect to instructors and peers. 2.Maintain a safe and inclusive environment. 3. Engage actively and responsibly in all activities. 4.Follow ethical practices in technology and scientific exploration. 5. Demonstrate teamwork and leadership in group projects. Student's signature required.
*
Note to Parents Our goal is to provide a safe and enriching learning environment. While we strive to accommodate each child, we may not be able to meet all individual needs. Approved volunteers are welcome if their presence benefits the child and supports the SITC STEM program’s mission. We reserve the right to remove any student for disruptive behavior or violations of the Code of Conduct. Acknowledgment & Consent By participating, students and parents agree to responsible internet use and grant permission for the student's name, image, and likeness to appear in program materials, including the website, social media, and promotional content. Indemnity Agreement, the undersigned participant (or parent/guardian of a minor), assume all risks associated with the SITC STEM program and release its organizers, sponsors, and affiliates from any liability related to participation, including technology use, activities, and media publication.
*
Submit
Submit
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