Explore STEM across the Great Lakes Bay Region: Registration Form
Complete this form and log five (5) STEM experiences (in-person or virtually) across the Great Lakes Bay Region to win a prize from the MiSTEM Network (while supplies last).

To be eligible, you will need to visit and/or attend five (5) different STEM destinations or programs and take photos of your child participating in STEM activities.  This may be done in-person or remotely.  Please send the pictures to STEM@greatlakesbay.org 

Also, feel free to post them on social media and tag us at Twitter: @stemgreatlakes or Facebook: @stempipeline.

You can e-mail all five STEM experiences at one time, or send them after each visit. All experiences must be completed by December 31, 2021 to be eligible for a prize.

For more information, please visit: https://www.stempipeline.com/out-of-school-time/

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Optional: Please consider providing an e-mail address for future communications, events and opportunities available from our Out-of-School Time STEM Network partners.
Child's First Name *
Child's Last Name *
Age of child? *
Gender your child identifies as? *
Race/Ethnicity (as defined by the Census 2020). *
Does your child qualify for free/reduced meals? *
Please provide an address where the prize should be mailed.
Street Number and Name (include Apartment number) *
City *
Zip Code *
Photo Release:  I give my permission for the Great Lakes Bay Regional STEM Impact Initiative to use my child’s photo on social media and in printed materials used to promote STEM learning in the Great Lakes Bay Region.  This also includes our website https://www.stempipeline.com *
STEM Experience #1: Please choose the organization/program that hosted the STEM experience.
Did you e-mail the picture to STEM@greatlakesbay.org?
Clear selection
STEM Experience #2: Please choose the organization/program that hosted the STEM experience.
Did you e-mail the picture to STEM@greatlakesbay.org?
Clear selection
STEM Experience #3: Please choose the organization/program that hosted the STEM experience.
Did you e-mail the picture to STEM@greatlakesbay.org?
Clear selection
STEM Experience #4: Please choose the organization/program that hosted the STEM experience.
Did you e-mail the picture to STEM@greatlakesbay.org?
Clear selection
STEM Experience #5: Please choose the organization/program that hosted the STEM experience.
Did you e-mail the picture to STEM@greatlakesbay.org?
Clear selection
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