FIS Intake and Exit Form

Frontline Innovation Studios Enrollment Application

Fill out the form completely to be an eligible participant
Date

MonthDayYear
Date
Which subject are you most interested in?
RoboticsCoding & GamingDigital MediaDrone Aerial & Aviation TechnologyHealth Science & Anatomy w/ VRArtificial IntelligenceData AnalyticsNone
Student Applicant Information
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
What school do you attend?
What grade are you in?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student E-mail
Phone Number

Area CodePhone Number
How do you see yourself in the future? What do you want to be or do? What are your passions?
Why do you want to join Frontline?
What do you like about technology? How do you use it daily?
Your Parent's Information
Parent Name

First NameMiddle NameLast Name
Parent E-mail
example@example.com
Parent Number

Area CodePhone Number
Alternate Number

Area CodePhone Number
PROGRAM REQUIREMENTS
• Attendance: Full and undivided attendance for all 15 weeks is mandatory.
• Engagement: Active participation in class and completion of assignments are
required.
• Extracurricular Conflicts: Students must not participate in conflicting
extracurricular activities during the program’s duration.
• Academic Performance: Students must maintain a minimum 3.0 GPA or have A's
and B's in core academic classes to qualify and remain in the program.
SCHOLARSHIP REMINDER
• This after school technology enrichment program is fully funded through a scholarship opportunity. This covers the cost of participation for ELIGIBLE students.

If your student does not adhere to the aforementioned requirements, they will be immediately dismissed from the program.
I have read and agree to all terms set forth in this document.
[TYPE FIRST AND LAST NAME TO SIGN AND SUBMIT]
Signature

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Have a question, Concern or comment?

Give us a call at 407.376.8806

or email Chrissandra@frontlineoutreach.org
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Frontline Innovation Studios Enrollment Application

Which subject are you most interested in?

Student Applicant Information

Your Parent's Information

PROGRAM REQUIREMENTS

SCHOLARSHIP REMINDER