Tech Savvy Student Application

Please note that we have a limited number of spots and unfortunately are not able to accept all students who submit an application.
We do strive to create a diverse cohort of students from the greater Boston area.

July 22-26, 2019

I. GENERAL INFORMATION

First Name
Last Name
Age
Birth date (mm/dd/yyyy)
Student's E-Mail
Home Street Address
Apt.
City
State

Zip Code

Home Phone
Student's Mobile Phone

What grade are you currently in? 6th 7th

Is your family enrolled in SNAP, MA Health or TAFDC? YES NO
If you answered yes to above, please read information re: tuition

Name of Parent/Legal Guardian #1:
Daytime Phone:
Mobile Phone:
Email:

Name of Parent/Legal Guardian #2:
Daytime Phone:
Mobile Phone:
Email:

ACADEMIC INFORMATION

Name of School You are Attending:
Street Address:
City: State: Zip:

Name of a science or engineering teacher who can provide a recommendation for you:
Teacher's email:

Note: We will send an electronic recommendation form to that teacher.

STUDENTS: PLEASE ANSWER THE FOLLOWING QUESTIONS IN YOUR OWN WORDS AND WITHOUT ASSISTANCE. Please try to be as thorough as you can so that we are able to learn more about you.

1.) Why are you interested in attending the program?

2.) Describe a science or engineering class that you found very interesting.

3.) What kind of activities do you enjoy doing outside of school?

4.) Have you participated in other science, technology, math or engineering
programs before? If so, please list and describe your experience(s).

5.) What do you think you'll be doing in 10 years?

6.) Name an accomplishment of yours that you are proud of.