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STEM Corps Application Form

Please fill out the form below to apply for a seat in STEM Corps.  After we receive the application, we will contact the student’s parents to come in for an orientation.  All information is confidential.

    All fields are required.

    Student Name

    Student's School

    Student Email

    Confirm Student Email

    Preferred Days

    Preferred Locations

    Parent/Guardian Name

    Parent/Guardian Email

    Confirm Parent Email

    Parent Phone

    Referral Type:
    Other Student or ParentCMG StaffNewspaper/TV/RadioSocial Media (Facebook, Twitter)School DistrictCourt System
    Other Referral: