SLOAN STEM+Arts Summer Camp Scholarship Application Form
2024
Student's Name (Each student will need to a separate scholarship form)
*
First Name
Last Name
Student's Gender
*
Male
Female
Student's Age
*
Ethnicity
*
African American
Hispanic
Asian
Caucasian
Other
Grade as of 2023-2024
*
PREK-2
3-6
Current School District
*
Student's T-shirt Size
*
Please Select
Child XS
Child S
Child M
Child L
Child XL
Adult XS
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
Please Explain the Reasons for the Need.
*
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Parent/Guardian Cell Phone
*
-
Area Code
Phone Number
Parent/Guardian Highest Degree of Education
*
No Degree
High School Diploma or GED
Some College
Associates
Bachelor's Degree
Master's Degree
Doctorate or higher
Parent/Guardian Household Annual Income *(Private for grant info only will not be shared)
*
$0-$24,999
$25,000-$49,999
$50,000-$99,999
$100,000-$149,999
$150,000+
Emergency Contact Name
*
First Name
Last Name
Relationship
*
Mother
Father
Grandparent
Aunt
Uncle
Sibling
Babysitter/Nanny
Other
Parent/Grandparent/Legal Guardian
Is there any close relative in STEM+Arts fields?
Yes or No (What field?)
Does the student have any special needs, allergies, chronic illness, or medical conditions? If yes, please describe.
*
Sloan STEM+Arts staff or volunteers cannot administer medications during camp
Submit
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