Imagine Corps 2021 Application

Questions? Contact Joe Gammal at jgammal@synecticsworld.com
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Email *
Student's Full Name *
Student's Date of Birth *
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Student's Address (Street, City, Zip, Country) *
Student's Telephone *
Student's  School *
Grade entering in September, 2021 *
Parent/Guardian Contact Name *
Parent/Guardian Phone # *
Parent/Guardian Email Address *
Q1. What about the program calls to you? Why are you interested? (Please offer a headline or two and elaborate.) *
Q2. In what ways can you imagine applying what you learn to your world? (Please offer a headline or two and elaborate.) *
Q3. What is an animal that represents, metaphorically or symbolically, an important aspect of the person you are or want to be? Find any photo of that animal. Take a look at it and explain below the connections you make. The magic is in the connections! (Please offer a headline or two and elaborate.) *
Q4 Which session are you wishing to attend? (Or note a desired future session as we consider adding them.) *
Once admitted and prior to attending my Imagine Corps session, I understand I'll be paying a program fee of $399 for BTT or $799 for ITW (unless adjusted for scholarship), including follow-up coaching, refinement labs, and concept jam. *
Required
Image Waiver: I give my permission for my or my teen's image in photographs or videos in which he or she appears to be used by Imagine Corps for publicity purposes.
Scholarships -- Thanks to the generosity of early supporters, there are a few scholarships available for families that, especially in this time of difficulty, could not otherwise afford to participate in Imagine Corps. Scholarships are awarded on the basis of demonstrated need, motivation, and potential benefit to the student.
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Thank you so much for your interest in joining Imagine Corps!!!!!!
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