Fall 2022 K-12 Application

Thank you for your interest in Science Club for Girls! WE ARE CURRENTLY FULL AND ARE NO LONGER ACCEPTING APPLICATIONS!

Once again our open enrollment Fall 2022 Science Club for Girls' clubs will be held virtually via Zoom.

All girls and and gender expansive youth in the greater Boston area in grades Kindergarten through 12th grade are welcome to apply for Fall 2022 clubs.

If the number of applicants exceeds the number of spaces available, priority placement will be given to participants who are the most underrepresented in STEM (people of color, those demonstrating economic need, and/or students who are first generation college bound), as per the mission of Science Club for Girls.

Submission of this application DOES NOT guarantee admission.

We are not able to accept applications for Junior Kindergarten or K1 students.

Participants should have access to a computer, tablet or smart phone and internet during club meeting times. All other club materials will be provided to the participants.

If you need assistance with filling out the application below, please email or call Cristina Ullmann at cullmann@scienceclubforgirls.org or 617-391-0361 ext 2.

Select your child's grade for the 2022-2023 academic year:

Greater Boston Area K-5 Clubs

Our Fall 2022 open enrollment Science Clubs are offered on the following days for girls and gender-expansive youth in Kindergarten through 5th grade.

Mondays 4:00pm - 5:00pm

October 3, 17, 24, 31, November 7, 14, 21 and 28

Tuesdays 4:00pm - 5:00pm

October 4, 11, 18, 25, November 1, 8, 15, 29

Thursdays 4:00pm - 5:00pm
October 6, 13, 20, 27, November 3, 10, 17 and December 1

Saturdays 10:30am - 11:30am

October 8, 15, 22, 29, November 5, 19, December 3, 10

*Due to high demand, please ensure that your child misses no more than two sessions.

For questions, please contact Science Club for Girls at scfgprograms@scienceclubforgirls.org or 617-391-0361.

Greater Boston Area STEMinistas 6-8 Clubs

Our Fall 2022 open enrollment Science Clubs are offered on the following days for girls and gender-expansive youth in 6th through 8th grade.

Mondays 4:00pm - 5:00pm

October 3, 17, 24, 31, November 7, 14, 21 and 28

Tuesdays 4:00pm - 5:00pm

October 4, 11, 18, 25, November 1, 8, 15, 29

Thursdays 4:00pm - 5:00pm
October 6, 13, 20, 27, November 3, 10, 17 and December 1

Saturdays 10:30am - 11:30am

October 8, 15, 22, 29, November 5, 19, December 3, 10

*Due to high demand, please ensure that your child misses no more than two sessions.

For questions, please contact Science Club for Girls at scfgprograms@scienceclubforgirls.org or 617-391-0361.

Greater Boston Area 8th-12th Junior Mentor Clubs

Our Fall 2022 open enrollment Science Clubs are offered on the following days for those in 8th through 12th grade. 8th grade and High Schoolers participate in our Junior Mentor Program where they assist our adult mentors in leading the science clubs.

Mondays 3:30pm - 5:30pm VIRTUAL

October 3, 17, 24, 31, November 7, 14, 21 and 28

Tuesdays 3:30pm - 5:30pm VIRTUAL

October 4, 11, 18, 25, November 1, 8, 15, 29

Tuesdays 3:00pm - 4:30pm KING OPEN SCHOOL

October 4, 11, 18, 25, November 1, 8, 15, 29

Wednesdays 2:30pm - 4:30pm EAST SOMERVILLE COMMUNITY SCHOOL

September 14, 21, 28, October 5, 12, 19, 26, November 2, 9, 16, 30, December 7, 14

Thursdays 3:30pm - 5:30pm VIRTUAL

October 6, 13, 20, 27, November 3, 10, 17 and December 1

Thursdays 2:30pm - 4:30pm MOTHER CAROLINE ACADEMY

October 6, 13, 20, 27, November 3, 10, 17 and December 1

Fridays 2:30pm - 4:45pm AMIGOS SCHOOL

October 7, 14, 21, 28, November 4, 18, December 2 and 9

Saturdays 10:00am - 12:00pm VIRTUAL

October 8, 15, 22, 29, November 5, 19, December 3, 10

*Due to high demand, please ensure that your child misses no more than two sessions.

For questions, please contact Science Club for Girls at scfgprograms@scienceclubforgirls.org or 617-391-0361.

Child's Information

Child's First Name

Child's Last Name

Optional Child's Preferred Name

Child's Gender Pronouns

Child's Date of Birth (MM/DD/YYYY)

Child Address

Child Address 1

Child Address 2

Child City

Child State

Child Zip

2022-2023 Academic Year Information

Child's Grade

If child attends home school, please indicate "Home School" below.

School - Complete Name

School City

School State

Teacher and Room Number are only required if applying for an afterschool program. If unknown at the time of this application, please leave blank and we will follow up with you.

Teacher's Last Name

Room Number

Medical History: Please indicate any medical issues or conditions, such as allergies, that we should know about. For example, foods, latex, medicines, bee stings, asthma, etc. If no allergies or medical issues, please enter None. (255 characters maximum)

Accessibility: Science Club for Girls has made efforts to ensure our programs are inclusive to individuals with disabilities. If you find that our programs are not accessible to your child, please contact us at scfgprograms@scienceclubforgirls.org to discuss accommodations. Is there any important information we should know that will aid us in working with your child to ensure their success in Science Club for Girls? If there is no important information, please enter None. (255 characters maximum)

Science Club Selection

Has your child previously participated in SCFG?

How did you hear about us?

Other Hear About Us

Please select the time and date for your Science Club.

K-5th Grade Options

K-5th Grade Options:

6th-8th Grade Options

6th-8th Grade Options:

8th-12th Grade Options

8th-12th Grade Options:

Family Considerations

Does your child have a sibling also applying for or currently participating in a Science Club for Girls program?

Sibling Name(s)

Are there any additional family circumstances that we should consider if the number of applicants exceeds the number of spaces available? (255 characters maximum)

Demographic Information

To keep Science Club for Girls' programs free, we get funding from many sources. Most ask for information about the background of our participants. Please help us keep Science Club for Girls FREE by filling out this information. This also helps make sure we reach a diverse group of participants.

All information is confidential. We will never share details about your specific child(ren). We share this information for all participants as a whole. For example: 40% of participants are Latina; 50% are from low income families.

Child's Racial/Ethnic Background

Other Racial/Ethnic Background

Is your child eligible for a Free/Reduced Lunch program?

What is the total income for the household at which your child resides?

How many people reside in your household?

What is the primary language spoken in your child's home?

Other Language

Please list any additional language spoken in your child's home:

Parent/Guardian 1 Highest Education Level

Parent/Guardian 2 Highest Education Level

Parent/Guardian Information

Any Parent/Guardian listed will have permission to pick up your child from Science Clubs if necessary.

Parent/Guardian 1 Information

The parent/guardian listed here will be the primary recipient of Science Club for Girls emails, including club enrollment, updates, and special events.

Parent/Guardian 1 Relationship to Child

Parent/Guardian 1 First Name

Parent/Guardian 1 Last Name

Does Parent/Guardian 1 have the same address as your child?

Parent/Guardian 1 Address

Parent/Guardian 1 Address 1

Parent/Guardian 1 Address 2

Parent/Guardian 1 City

Parent/Guardian 1 State

Parent/Guardian 1 Zip

Parent/Guardian 1 Preferred Contact during Science Club hours:

Parent/Guardian 1 Mobile Phone

Parent/Guardian 1 Home Phone

Parent/Guardian 1 Work Phone

Parent/Guardian 1 Email

Parent/Guardian 2 Information

If no Parent/Guardian 2, then leave blank.

Parent/Guardian 2 Relationship to Child

Parent/Guardian 2 First Name

Parent/Guardian 2 Last Name

Does Parent/Guardian 2 have the same address as your child?

Parent/Guardian 2 Address

Parent/Guardian 2 Address 1

Parent/Guardian 2 Address 2

Parent/Guardian 2 City

Parent/Guardian 2 State

Parent/Guardian 2 Zip

Parent/Guardian 2 Preferred Contact during Science Club hours:

Parent/Guardian 2 Mobile Phone

Parent/Guardian 2 Home Phone

Parent/Guardian 2 Work Phone

Parent/Guardian 2 Email

Emergency Contact

In case of an emergency and a parent/guardian cannot be reached, please indicate an Emergency Contact that we may reach during Science Club hours:

Emergency Contact Name

Emergency Contact Phone Number

Relationship to Emergency Contact

Granting Permissions

Child's Full Name

Parent or Guardian's Name

Today's Date

Permission to Participate

I understand that my child will be under the supervision of the SCFG staff and/or volunteer mentors who are trained, supervised and CORI background checked by SCFG. In consideration of my child being allowed to participate in these programs, I hereby agree on behalf of myself and my child, to release the SCFG Organization, their employees, agents and volunteers from any and all claims including negligence, which may be asserted by me or my child, or on behalf of my child, arising from or relating to my child’s participation in the Science Club for Girls.

I understand regular attendance and good behavior at clubs are essential parts of Science Club for Girls, and I have reminded my child of the importance of both. I also understand that programs are continually evaluated for quality and effectiveness, and that my child will be part of these activities, but that data gathered will be shared only in aggregate with no individual identifying information associated.

I understand that submission of this application does not guarantee acceptance into a Science Club for Girls program.

Permission to participate - please select:

Permission to Participate

If you choose "No" to the preceding question, your child's application will be discarded and she will not be placed in a Science Club for Girls program. If you wish to proceed with this application, please select "Yes" above.

Image Release

On behalf of my minor child, I hereby acknowledge and voluntarily consent to the use of my child’s photograph, video footage or other likeness and description of her/him by Science Club for Girls, Inc. (including its successors and assignees, “SCFG”) and by any organization that sponsors or partners with SCFG in any SCFG Programming, in any of SCFG’s or Sponsors' website, video projects, organizational communications, promotional materials, including but limited to social and other media, as SCFG/ Sponsors see fit for any and all purposes consistent with SCFG’s mission and as a 501(c)(3) tax exempt organization and for Sponsor’s related non-commercial purposes. I understand that my child’s first name may be disclosed but that SCFG and Sponsors will not, without my prior written consent, disclose my child’s full name.

I hereby release you and anyone using said videotape, photos, or other material from any and all claims, damages, liabilities, costs, and expenses for which I now have or may hereafter have by reason of any use thereof.

I understand that the provisions of this release are legally binding.

Permission for Image Release - please select:

By clicking “Submit” below,

I certify that I have read, fully understand and accept all terms of the foregoing statement

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