2016 Summer Engineering Experience Application CLOSED

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This application is now closed for the summer 2016. Please email Leyf Starling at astarli2@ncsu.edu if you have any questions.

What is student's first name? *

What is student's last name? *

Please provide a student email address.

We will use this to communicate important information regarding the camp.

How old will the student be at the start of camp (June 19, 2016)? *

Is the student male or female? *

Male

Female

What grade will the student be starting in August 2016 *

10th grade

11th grade

12th grade

What high school does the student attend? *

What is the student's home address? *

Please provide Street, City, State and Zip Code

Please provide a parent or guardian contact name. *

We will use this information in case of an emergency.

Please provide a parent or guardian contact email address. *

We will use this in case of emergency and to communicate important information regarding the camp.

Please provide a parent or guardian contact phone number. *

We will use this information in case of an emergency.

How did you find out about this summer opportunity? *

Please choose one.

Parent

Teacher

Counselor

Internet search

Other:

Please provide the contact name of a teacher or mentor who could be a reference for this student. *

We may contact this teacher or mentor for a reference.

Please provide the contact email of the teacher or mentor indicated above. *

Please provide the contact name of a teacher or mentor who could be a reference for this student.

Do you consider yourself to have low vision or are you totally blind? *

Please choose one. If you choose "other," please explain.

Low vision

Totally blind

Other:

What is the primary test format that you use for standardized tests in English/Language Arts? *

Please choose one. If you choose "other," please specify.

Regular print

Large print

Braille

Other:

Are you capable of traveling independently at your current school? *

Yes

What accommodations do you currently receive at school? *

Please list and explain as needed.

What is your current GPA? *

Please type in your current GPA and indicate if it is a 4.0 scale or not.

Please list all of the high school science courses you have taken or are currently taking and indicate what your final or current grade is in that class. *

Please indicate if any of these courses are AP courses.

Please list all of the high school math courses you have taken or are currently taking and indicate what your final or current grade is in that class. *

Please indicate if any of these courses are AP courses.

What extracurricular activities are you involved in? *

Please describe and indicate if you are recognized as a leader in these activities (for example, president of a club or captain of a team).

What achievements or awards have you received in school or out of school? *

Please list and provide brief description.

What are your plans for after high school? *

Briefly describe your goals following completion of high school.

Have you been to an engineering or other STEM-focused camp before? *

Please indicate yes or no. If yes, please briefly describe your experience.

What do you hope to gain from the Summer Engineering Experience camp? *

Briefly describe your goals for this experience and why you are interested in participating in this summer experience.

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