S.T.E.A.M P.L.U.S Registration Form

S.T.E.A.M P.L.U.S Registration Form

A separate registration form must be completed for each student. This is a FREE event! Thank you for registering for the S.T.E.A.M P.L.U.S. (+) Seminar Series! The seminar will occur October 17 & November 7, 2026at the Nannie J. Lee Memorial Recreation Center, 1108 Jefferson St. Alexandria, VA. Breakfast will be served at 10:30 am., and seminar sessions begin at 11:00 am and end at 2:00 pm. Participants will enjoy engaging STEAM experiences, Free SWAG Bags, weekly drawings, and fantastic Grand Prizes will be awarded! Participant must be present to win. To help us create an extraordinary experience for every participant, please provide the information requested below.
Participant's Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Provide the full name of the school the participant attends? Be sure to state if it a middle or high school.
What city is the school located in?
What grade is the participant currently in?
Age of the participant
Sex
I am a “first time” participant in the S.T.E.A.M. + Seminar. Check all that apply.
I am planning to attend the S.T.E.A.M + Seminars
T-shirt shirts are available in adult sizes only.
What is the S.T.E.A.M + participants ethnicity?

Other
What is the participants address?

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Name of parent or guardian

First NameLast Name
Email
example@example.com
Phone number of parent or guardian
Please enter a valid phone number.Format: (000) 000-0000.
Address of parent or guardian #1

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Address of parent or guardian #2

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Food allergies: Please list any food allergies. If there are none, enter "N/A."
Health conditions: Please list any health conditions we should be aware of. If there are none, enter "N/A."
Parent/ Guardian Consent information. Check all that apply.
Parent/ Guardian Full Name (Electronic Signature): By typing my full name below, I confirm that I am the parent/guardian of the participant and that I agree to the consent statement above.
Parent/ Guardian First and last name required
Which of the following organizations does the participant currently participate in? Select all that apply.

Other
The Links, Incorporated collects demographic information to better understand the communities we serve and to help evaluate the impact of our programs. Your responses will be kept confidential and will not be shared outside the organizations. Please select your estimated annual household income.
Name of the parent or guardian #1 attending the College Readiness sessions November 7

First NameLast Name
Name of the parent or guardian #2 attending the College Readiness sessions November 7

First NameLast Name
Should be Empty: