Pre-Engineering Program Application Fall 2024
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Attendee Information
Student First Name *
Student Last Name
 *
Student address (Primary) *
Birthdate  *
MM
/
DD
/
YYYY
Grade level *
Preferred Name/Nickname for Name Tag
Pronouns *
What school does the applicant attend?  Homeschooling is okay!
 *
Are they interested in STEM (Science, Technology, Engineering, and Math)? All levels of experience and interest are welcome. *
Are they interested in any of the following topics? Please check all boxes that apply *
Required
Are you able to attend all dates of the program? Please check all the dates your child will be able to attend!
 *
Required
Do you plan on using the family/friend discount? ($40 discount applies when a sibling, family member, or friend attends the program with you. This discount can only be utilized twice.)
Clear selection
Please indicate the family/friend's name(s) below
They will still need to fill out their own application
How did you hear about this program?
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