Missouri City NSBE JR explorers Interest Form
Complete this form to request more information about us. Please join us on Saturday, August 29, 3:00PM for a Virtual Information Session: Meeting link:https://www.google.com/url?q=https%3A%2F%2Fus04web.zoom.us%2Flaunch%2Fjc%2F74774740841&sa=D&source=calendar&usd=2&usg=AOvVaw3sEfDIbumCVwQJg5irkiQV Also see https://nsbe.org/pci/ for additional details about our pre-collegiate (PCI-chapter).
Today's Date
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Student Name
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First Name
Last Name
Student Email
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example@example.com NOTE: each student must have a unique email address
Parent/guardian Information
Parent(s)/Guardian(s) Name
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First Name
Last Name
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Parent Email
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example@example.com; if possible, a gmail account preferred
student Education Information
Student Grade Level
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Please Select
6
7
8
9
10
11
12
Name of School Attending
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Name of School District
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If Home School or Private; indicate location (City and State)
List any particular fields of STEM interested in studying and any/or any hobbies?
How did you hear about our organization?
Submit
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