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General Information

Are you a New or Returning Student?

New Student - Never Participated in E-CADEMY Before; A Returning Student - Participated in E-CADEMY last school year

To which Program are you applying?

How Did You Hear About Our Program?

Referral Name - First and Last

Church Name

Parent/Guardian Information

Parent/Guardian 1

First Name

Last Name

Mobile Phone

Work Phone

Relationship to Student

Parent/Guardian 2

First Name

Last Name

Mobile Phone

Work Phone

Relationship to Student

Address Information

Address Line 1

Address Line 2

City

State

Postal Code

Emergency Contact

First Name

Last Name

Mobile Phone

Work Phone

Relationship to Student

Essay Questions

Please answer the following question in 650 words or less: Why is STEM (science, technology, engineering, and mathematics) important to you?

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Why do you want to participate in this program?

What do you want to do when you grow up? How will this program support your goals?

Extracurricular and volunteer information (Optional)

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Please list any academic or educational awards and honors you received? (Optional)

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Multimedia information (optional)

You may include links to relavent content to support your application. Blogs, project portfolio, performance, presentations, etc.

Last Semester Report Card Upload

Your digital signature below confirms all information in this application (including any supplemental information) is factually true and honestly present and that you are the person submitting this application.