New Student Application Form 2025-2026

2025-2026 Student Application Form

Syracuse University Science and Technology Entry Program
To be eligible for the STEP Program, the applicant must have been a resident of New York State for at least 12 months prior to application and must be enrolled in grades 7-12 for the 2025-2026 academic year.
Section 1: Student Information
Name

First NameMiddle NameLast NameSuffix
Grade Level*

7th8th9th10th11th12th
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone *
Please enter a valid phone number.
T-shirt Size*
Date of Birth*

MonthDayYear
Date
Gender*

MaleFemaleNon Binary
Ethnicity*

Hispanic/LatinoAmerican Indian/Native AlaskanBlack/African AmericanAsian (excl. Pacific Islanders)Native Hawaiian/Other Pacific IslanderWhite Caucasian or OtherPrefer not to answer
New York State Resident*

YesNo
If you clicked yes, when did you become a New York State Resident?*
Country of Birth (If other than USA)
Permanent Resident Alien?*

YesNo
If yes, Registration Number*
Does student require any accommodations/have accessibility requirements? If yes, please describe:*
Section 2: Contact Information

** Parent and Student email address is required
Relationship to Student *
Legal Guardian Name*

First NameLast Name
Parent/Guardian Cell Phone*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Student Email*
example@example.com
Section 3: Emergency Contact Information
Name*

First NameLast Name
Cell Phone Number*
Please enter a valid phone number.
Relationship to Student*
*To the Parents/Guardians: Your signature on this application signifies that all the information given in this application is accurate and complete to the best of your knowledge in accordance with Federal and State regulations.
Parent Signature*

Clear
Student Signature*

Clear
Are you eligible for Free or Reduced Lunch?
Please upload a copy of your free and reduced lunch eligibility. You can obtain this from the main office at your school.

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2025-2026 STEP Student Authorized for Disclosure of Educational Information

This page must be completed in full in order to be eligible for STEP Program acceptance
Student Name*

First NameLast Name
School Name*
Grade Level*

7th8th9th10th11th12th
I am the person legally responsible for the above named individual and I authorize the Science and Technology Entry Program to obtain information from (please indicate your school): blanks* and release information to Syracuse University Science and Technology Entry Program (STEP) 419 Sims Hall Syracuse, NY 13244
I hereby authorize the disclosure of educational information between the Science and Technology Entry Program (STEP) and the School district indicated above, in accordance with the Family Educational Rights and Privacy Act (FERPA).

Specific information to be released or obtained includes the following confidential information necessary for educational services:

-          Student standardized test scores, Grades, and Report Card Information
-          New York State Student Identification System (NYSSIS) ID which is also known as the Student State ID.

-          Attendance Data and Suspension Data

-          Information on a Student’s Individual Education Plan (IEP)
-          Teacher/administration notes and correspondence

-          Individual course communications, assignments, and interim results

-          Other

This information is required for the purpose of any necessary and ongoing educational needs inclusive of evaluations and recommendations for further development.

By signing below I am stating that:

-          I understand the information disclosed, as permitted by this authorization, will not be re-disclosed by the receiving entity (and/or its affiliates). I do understand that local, state, and federal laws do exist to protect the confidentiality of this information.

-          I understand that I have the right to revoke and/or restrict this authorization at any time without penalty, provided that I submit a request in writing to the STEP Office.

-          I authorize the periodic, on-going disclosure of the above information. This authorization expires one year after date of signing or at disenrollment from services, whichever comes first. Re-authorization will be obtained after one year if information is still needed.
Parent Signature*

Clear
2025-2026 Student Questionnaire

Be sure to respond to all questions on this page. Information below is required by the New York State Education Department which provides funding for the STEP Program.
Student Name*

First NameLast Name
Is student presently enrolled in SU LPP?*

YesNo
Is student presently enrolled in NYGEAR UP?*

YesNoOther
Is student presently enrolled in Lemoyne LPP Program?*

YesNo
Is student presently enrolled in SUNY ESF STEP?*

YesNo
Is student presently enrolled in Lemoyne STEP Program?*

YesNo
Does student have an IEP or 504 plan? (Individualized Education Program)*

YesNo
Is student eligible for free or reduced lunch?*

YesNo
2025-2026 Informed Consent Form

It is critical that the coordinators of the STEP program collect information from students who participate in activities in order to continuously improve the program and meet the needs of the students, as well as participate in focus group sessions to discuss the program.

Your signatures below indicates that you are willing to have your child participate in the STEP program information gathering efforts. Choosing not to sign this consent from will in no way influence your child’s ability to participate in the STEP program.
Student Signature

Clear
Parent Signature

Clear
2025-2026 STEP Program Media Release

Press and Performance Release

I hereby give my permission to Syracuse University, its agents, successor, assigns and/or newspapers, radio, television or websites, statewide conferences to use my child’s photograph (whether still, motion or television) and recordings of my child’s voice, for publicity regarding the STEP Program.
Parent Signature*

Clear
Student Signature *

Clear
Required Document(s)

In order for your scholars application to be complete, we will need a copy of your scholars most recent report card (marking periods 1,2,3,4). Please upload the report card in the link below.
Report Card Upload*

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Should be Empty:

2025-2026 Student Application Form