OST/ C2 Pipeline Student Interest form

OST/ C2 Pipeline Student Interest form

We're glad that you're interested in joining our afterschool program. Our program is different because you help pick the topics and it works with what you're already doing in school. This is the first form. It is short. There are just 1-2 more forms that will be sent to you later after this form. They are not long either. They are from our partners: Wayne State University and the State of Michigan.
Please tell us your name*

First NameLast Name
What grade are you in?*
What school do you go to?*
If you go to a school other than Cody, Denby, Northwestern, Pershing, or Southeastern, we will have to share your information with our community partners. Is that okay?

YesNoPlease contact me first
Your personal email address- we cannot contact you through your school email address. You can put your parent/ guardian's email address if you do not have one.
example@example.com
How did you hear about the program? *
You can type "don't know."
What are you looking forward to by joining the program?
THANK YOU for completing this form. We're looking forward to joining the program.

A member of your school's team will be in touch soon.
Should be Empty: