2011 SIR Online Application

Thank you for applying to the 2012 SIR Program. Please fill in all information as completely and accurately as possible. All fields should be considered required unless otherwise specified. Upon submission, you should receive a confirmation email containing an application key. You will need this key to make updates to your application in the future.

Applicant Information

Specify your name and contact information.
First Name
Middle Name
Last Name
  Age Date of Birth :
Gender
Ethnicity*
Email Address
Confirm Email Address
Home Address
City
  State Zip
*optional

Parent/Guardian Information

Please specify information regarding your parent/guardian.
Parent/Guardian Name
Home Phone
Work Phone
Cell Phone*
Email Address
Home Address
City
  State Zip
*optional

Academic Information

Please provide us with information about your school, courses taken, and tests taken.
Grade
Current Overall GPA (e.g. 3.14)
School Name
  If your school is not listed in the drop-down list, please select 'Not Listed' and type the name of your school below.
Indicate which of the following courses you have taken or are currently taking.
Courses Taken Pre-Algebra Algebra I Algebra II
Geometry Trigonometry
Pre-Calculus Calculus
Chemistry AP Chemistry
Biology AP Biology
Physics AP Physics
Earth Science
Indicate which of the following tests you have taken. Specify whether you have passed or give the score received.
Tests Taken High School Assessment Test - MathematicsPassFail
High School Assessment Test - EnglishPass Fail
High School Assessment Test - GovernmentPass Fail
High School Assessment Test - Biology Pass Fail

SAT - Verbal Score
SAT - Mathematics Score
SAT - Written Score

Robotics Experience

Have you participated in any robotics-related events? (i.e. FIRST Robotics or Lego League) If yes, please specify the name(s) of the robotics events have participated in below.
Previous Participation Yes No
Robotics Event(s)
Have you participated in SIR before? If yes, please specify when.
Previous SIR Participation Yes No
Previous SIR Participation

Parental Permission

You must have permission from your parent/guardian in order to participate in the Summer Institute for Robotics program.
I certify that I have permission from my parent/guardian to participate in the 2012 Summer Institute for Robitics.