STUDENT APPLICATION FORM



[pic]

STEM Saturday Academy for Middle School

Saturdays February 14, 2015-March 7, 2015

In partnership with University of Memphis and Shelby County Schools we are pleased to offer the STEM Saturday Academy for Middle School Students (STEM SAMS). The mission of this program is to offer educational enrichment programs to the middle school students enrolled in Shelby County Schools to support the science, technology, engineering, and mathematics (STEM) needs of students. This will be an academically engaging, fun, and exciting program for Memphis area middle school students.

The program enrolls middle school students in project-based learning, as well as provides opportunities to engage in engineering activities in robotics and rocketry.  There will also be opportunities for the students to hear from guest speakers in the science fields.  While students participate in hands-on design projects, they learn how to work responsibly in teams, develop leadership skills, and learn about time management. They attend classes that enhance their skills in mathematics as well as English, with a focus on critical thinking, writing and speaking skills.

* This program is funded by The National Science Foundation.

 The actual instructional program starts at the beginning of the spring semester and classes will meet for three (3) hours each day on four (4) consecutive Saturdays beginning on February 14 until March 7, 2015.  During each instructional session, there will be two (2) 75 minute class sessions where the students will be engaged in forensic science and math instruction, which will be followed by a period where the students will participate in robotics and rocketry activities. 

Parent or Guardian Information

Applicants should have a B or better average in their academic courses, especially in math and science.

The program hours are from 9:00 a.m. - 12:00 p.m. every Saturday.

All program functions are held at the University of Memphis’ College of Engineering Building. This facility is located at 3795 Central Avenue.  Program staff is available for supervised research and individual consultations.  There is no fee to participate in the STEM SAMS, but space is limited to the first two hundred students. Past participants are welcome to apply.

Students will be exposed to some of the topics below:

Mindset Robots: Students learn about the fascinating role that robots play in our lives. More and more, this technology is helping to improve the way we live and manufacture items. Students learn how to operate, program, and use robots in different environments.

Water Rocketry: Students learn about the scientific principles of flight, propulsion, and aerodynamics. Newton’s laws of motion are introduced and explained in practical terms. Students construct a rocket and launch it as a culminating activity.

K'NEX: Bring STEM concepts to life with K'NEX® Education! The Real Bridge Building set is designed to assist students in their study of the history, function, structural design, geometry and strength of bridges. They will also investigate concepts related to the physical properties of materials and their application in the placement, design, and construction of bridges

Important Dates

1. Application deadline – Monday, February 2, 2015 or until all remaining seats are filled.

2. Successful candidates will be notified of acceptance by Friday, February 6, 2015.

Application Instructions

1. The completed Participant Online Application form.

2.  A 100-300 word essay stating why you want to participate in the program.

3.  Most Recent Report/Progress Report.

*Required

Application Instructions

1. The completed Participant Application form.

2. A 100-300 word essay stating why you want to participate in the program.

3. Grade report showing spring 2015 grades.

PARTICIPANT APPLICATION

STEM SAMS PROGRAM

Program Dates: February 14, February 21, February 28 and March 7 Application Deadline: February 6 or until filled

A complete application includes the following items:

4. Completed Participant Application form

5. A 100-300 word essay stating why you want to participate in the program.

6. Most Recent Grade Report (Report Card or Progress Report)

Applications will be accepted until February 6, 2015, or until all openings are filled. If possible, have a teacher, counselor, or parent mail all items in one packet to:

Tamara Jones

East Virtual STEM Academy

3225 Walnut Grove

Memphis, TN 38111

901-416-6650 (fax)

Jonest4@

Applicants will be notified of acceptance immediately. We will accept a maximum of (200) students for the STEM Saturday Academy for Middle School students 2015 spring semester program. Past participants are welcome to apply.

To be completed by potential participants in the STEM SAMS program.

6TH – 8th graders are eligible for STEM SAMS

PLEASE PRINT CLEARLY

1. ______________________________________________________________________________________

Last Name First Name Middle Name

2. ______________________________________________________________________________________

Address Apt. # City State Zip Code

3. _________________________ ________________________ __________________________

Home Phone # Alternate Phone # E-mail

4. __________________________________ Gender: ( Male ( Female

Date of birth

5. ________________________________ ____________________ ____________________________

Father’s Name Work Phone # E-mail

6. ________________________________ ____________________ ____________________________

Mother’s Name Work Phone # E-mail

7. Emergency Contact _______________________________________________________________

Name Relationship Phone #

8. ___________________________________________________________ 6 7 8

Name of School School District Circle Current School Grade

9. Areas of Career Interest: _________________________________________________________

10. Hobbies and Strong Interests: ______________________________________________________

______________________________________________________________________________

11. Honors and Awards ________________________________________________________

_______________________________________________________________________________

12. Ethnicity: ( Amer. Indian ( Black ( White ( Latino/Hispanic ( Asian-American

13. How did you hear about STEM SAMS? (Check all that apply)

( Teacher ( Principal ( East Virtual STEM participant ( School Presentation ( Friend

( E-mail ( Counselor ( Program Flyer ( Website ( Other: _____________________

14. Participant Tee Shirt Size (adult size): (Small (Medium (Large (1X (2X (3X

15. PARENT’S/GUARDIAN’S CONSENT: As the parent/guardian of the above named student, I certify that my son/daughter/ward has my permission to participate in the STEM SAMS Program. It is my understanding that he/she will be subject to regulations of the STEM campus, which he/she will attend. I understand that should a health emergency arise, I will be notified, but that if I cannot be reached by telephone, such medical treatment as deemed necessary by competent medical personnel is authorized.

16. __________________________ _________ _________________________ _______

*Signature of Parent/Guardian Date Signature of Student Date

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download