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Math SEAL Boot Camp
(To Be Completed by Parent/Guardian)
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Email
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Your email
Select which class you'd like to enroll in. All classes will be held from 9:00 AM- 12:00 PM, having a maximum of six students.
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June 26- 29, 2023
July 17- 20, 2023
July 24- 27, 2023
July 31- Aug. 3, 2023
1. Youth’s Full Name
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Your answer
2. Today's Date
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MM
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DD
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YYYY
3. Parent/Guardian Name
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Your answer
4. Relationship to Youth
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Your answer
5. Address to use when shipping the supply kit (street, city, state, zip):
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Your answer
6. Home Phone:
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Your answer
7. Work Phone:
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Your answer
8. Cell phone:
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Your answer
9. Youth's Age:
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Your answer
10. Youth's Date of Birth:
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MM
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DD
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YYYY
11. Youth's School Grade:
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Your answer
12. Youth's Gender:
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Female
Male
14. School:
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Your answer
15. Emergency Contact Name:
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Your answer
16. Emergency Contact Phone Number:
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Your answer
17. How are you paying the 2023 Math SEAL Virtual Bootcamp tuition?
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VA K-12 Learning Acceleration Grant- full tuition of $1,000 covered
Personal funding, I would like to learn more about scholarships available to lower the cost.
Personal funding (check, credit/debit card) to pay $1,000 in tuition
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