SEI 2008 Application: Part I For The Student

Your Name:

Date of Birth (mm/dd/year):     Age:     Gender (M/F):

Minority Group/Race:     Address:

City:     Zip Code:

Phone [(xxx)xxx-xxxx]:     Current Grade in School:

T-Shirt (Adult) Size:

Name of School:     School Address:

City:     Zip Code:

Award/Honors:


Current School Activities:


Math/Science Projects, if any:


Computer Experience/Knowledge of Computer Language:

Previous SEI Attendance: No   Yes  

If yes, state Phase: and Year:

See Phase Description to Select:

By clicking submit you are signing and submitting the application.  

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