23_TFI_PACTS_Application

Thank you for your interest in The Franklin Institute PACTS program. We are currently accepting applications for the Fall 2024 Academic Year.
Name*

First NameLast Name
Age*
Grade Level/Year (in Fall 2024)*
School Attending*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone*
Email*
example@example.com
Parent/Guardian Name*
Which PACTS program(s) are you interested in?*

RoboticsScience in the CityScience Investigators
Emergency Contact Name/Phone Number
Which areas of science do you like?*
Are you involved in extracurricular activities? If so, please list them below*
Is there anything additional you would like us to know about you?
Student Signature:*

Clear
Date*

MonthDayYear
Date
Parent Signature:*

Clear
Date:*

MonthDayYear
Date
I authorize my child to participate in the PACTS Program. I grant permission to him/her to take part in activities held at The Franklin Institute and field trips. I also understand that any behavioral misconduct from my son/daughter at The Franklin Institute and on field trips may result in dismissal from the PACTS Program. I grant permission for images captured of my child to be used by The Franklin Institute and its authorized partners to publish these images in promotional materials and publications, and wave any rights of compensation or ownership thereto.
222 N. 20th Street Philadelphia, PA 19103
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Thank you for your interest in The Franklin Institute PACTS program. We are currently accepting applications for the Fall 2024 Academic Year.