e Steam Saturday School
Sumter Business Tech Hub at SumterBCC
Parent Name
*
First Name
Last Name
Child Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
How did you hear about us?
*
Please Select
Sumter Black Chamber Website
Friend
Family
Internet
Referred by School Agency
Please Specify
*
Does Your Child Currently Receive e Steam Education?
Suggestions if any for further improvement:
Will you be willing to recommend us?
Yes
No
Maybe
I Understand that my child must be between the ages of 4yr and 8yrs old to participate at all times?
Yes
No
I Understand that my child must wear a black collared polo shirt and khaki's? at all times?
Yes
No
I Understand that my child's participation fee is $40 Monthly?
Yes
No
I Understand that admittance is on a first come first serve bases?
Yes
No
I Understand that admittance is based on income of parents?
Yes
No
I Understand that admittance is denied for all scholars who attend or recieve steam or stem education currently?
Yes
No
I Understand that only one child per residence maybe admitted?
Yes
No
Please give reference whom you feel may need e steam workshops:
Full Name
Address
Contact Number
1
Submit
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