SITC STEM registration form

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 NameMiddle NameLast Name
Birth Date*

MonthDayYear
Gender*
Address*

Street Address

CityState / Province

Postal / Zip Code
Mobile Number*
Student E-mail*
example@example.com
Are you a US Citizen?*

YesNo
What is your race?*
Parent/Guardian Name *

First NameMiddle NameLast Name
Address*

Street Address

CityState / Province

Postal / Zip Code
Parent/Guardian Number*
What is the name of your high school?*

Street Address

CityState / Province

Postal / Zip Code
What grade is the student?*
Are you available for a personal or phone interview with the selection committee?*

YesNo
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.*

Powered by Jotform SignClear
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.*

Powered by Jotform SignClear
Should be Empty:

SITC STEM program registration form