JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2023 ExCel Application for Summer Programs
This form is due in its entirety by April 28, 2023.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student Name
*
Your answer
Parent/Guardian Name
*
Your answer
Home Address
*
Your answer
Phone Number
*
Your answer
School
*
Your answer
Grade 2022-2023
*
Your answer
Name of Enrichment Program
*
Your answer
Location of the Program
*
Your answer
Dates of Program
*
Your answer
Purpose of the program
*
You may also email any relevant or supporting materials to
brigit.storhoff@decorah.k12.ia.us
Your answer
Why do you want to attend this program, and what do you hope to gain from attending?
*
Your answer
How will you share your experience with other peers and teachers?
*
Your answer
What is the total cost of the program?
*
Your answer
Do you have funding from other sources? (fundraising, scholarships, parent/guardian, personal contribution, etc.) If so, how much?
*
Your answer
How much are you requesting from the ExCel grant?
*
Your answer
Are there any special circumstances the selection committee should consider?
Your answer
To complete this application, please contact a teacher to recommend you for this program. The teacher should email brigit.storhoff@decorah.k12.ia.us with their recommendation. This is simply an email stating you have shared this program with them and they support your attendance. Please list the faculty member you plan to contact below -
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Decorah Community School District.
Report Abuse
Forms
