IIMF High School & Middle SchoolS.T.E.A.M. Curriculum RegistrationFebruary 4, 20238:00 AM - 3:30 PM

IIMF High School & Middle School
S.T.E.A.M. Curriculum Registration
February 4, 2023
8:00 AM - 3:30 PM

Student Name

First Name

MI

Last Name

Student Email Address (noname@noname.com)

Student Phone Number (xxx-xxx-xxxx)

Address

Race

Gender

School

Graduation Year

Grade

If you picked "other" for school, please enter the name below.

Do you receive free/reduced lunch

YesNo

Please indicate what size shirt you wear. (shirts will be men's t-shirt sizes)

Parents Information

First Name

Last Name

Parents Email (noname@noname.com)

Parents Phone Number (xxx-xxx-xxxx)

Parent Address

Parents Information

First Name

Last Name

Parents Email (noname@noname.com)

Parents Phone Number (xxx-xxx-xxxx)

Parent Address

Do you have a STEAM T-shirt from a past workshop?

YesNo

Contact Information