STUDENT APPLICATION FORM – SUMMER 2014

Rising Eighth Graders STEM Camp at the University of Texas—Pan American

August 3rd – 8th

Camp Information:

This weeklong residential camp promoting science, technology, engineering and mathematics is organized to provide activities, experiments and projects for rising 8th-grade STISD students. The camp will focus on increasing students’ STEM skills while introducing them to college life and promoting Science, Technology, Engineering and Mathematics (STEM) subjects as a potential career path. Campers will attend classes that include problem solving, research and communication skills incorporated with STEM subjects including physics, engineering and Earth sciences.

The camp will be held at the University of Texas—Pan American, located at 1201 W. University Drive in Edinburg, Texas. Students will be housed in a dorm on the university’s campus under strict supervision.

Who Should Apply?

  • Rising 8th grade students at STPA
  • Students interested in a future STEM career or students interested in learning more about STEM related fields

Application Process:

  • Parent/Guardian and student complete the attached student application form.
  • Student writes a one page (250 word max) essay.
  • Student gives current Science and Math teacher a recommendation form to be completed.

APPLICATION DEADLINE IS WEDNESDAY APRIL 30, 2014 NO EXCEPTIONS.

UTPA STEM Camp Student Application Form Summer 2014

APPLICATION DEADLINE IS WEDNESDAY April 30, 2014

Please type or print clearly in dark blue or black ink.

Name of Current 7th Grade Student: ______

Home Address: ______

______

CityState Zip Code

Student Email Address: ______

Student Cell Phone (if applicable): ______

Please list school organizations, any science and/or mathematics activities (Science Fair, math club, after school programs, summer programs, etc.) you have participated in. Include awards received and offices held.

______

Please list any community activities and/or community groups that you have been a part of.______

Please list any other activity or achievement that you would like to share with the selection committee. ______

______

______

How confidentare you in your ability to set goals? (Circle response)

Not at all ConfidentNot ConfidentSomewhat ConfidentVery Confident

How confident are you about what you want to be when you grow up? (Circle response)

Not at all ConfidentNot ConfidentSomewhat ConfidentVery Confident

How often do you reach the goals you set? (Circle response)

NeverSometimesOften Always

How often do you think about high school, college, and beyond (Circle response)

NeverSometimesOften Always

How committed are you to your school work?(Circle response)

Not committed Somewhat Committed CommittedVery Committed

A student-written essay must be included with this application. The student essay is to be typed using Arial, Helvetica, or Times New Roman and a 12 point font. The essay is not to exceed 250 words (one double-spaced page). In your essay, tell the selection committee why you are interested in attending the STEM camp at The University of Texas—Pan American. Include in your essay what you hope to gain from this experience and how you think it will help you in the future. Be sure to write your name at the top of your essay.

______

Signature of StudentDate

Parent/Guardian Information

Instructions: Please complete the following information for at least one custodial parent, guardian, both, if available.

Name of Parent or Guardian: ______

Relationship: ______Daytime Phone No.: ______

Cell Phone No.: ______Home Phone No.: ______

Email Address: ______

______

Signature of Parent or GuardianDate

Name of Parent or Guardian: ______

Relationship: ______Daytime Phone No.: ______

Cell Phone No.: ______Home Phone No.: ______

Email Address: ______

______

Signature of Parent or GuardianDate

APPLICANT REFERENCE FORM

Student’s Last Name: ______First:______

Name of Math or Science Teacher: ______

TO THE EVALUATOR: Please fill out the information included in this form. When you have completed the form,please place it in a sealed envelope with the student’s name printed on the front of the envelope (the student must provide the envelope to the teacher). This form must be submitted to the STPA Administration Office by April 30, 2014. Thank you very much.

Please rate the student in all categories relative to other 7th graders. Place a () in the field that best describes the student’s characteristic. Please include comments that provide any information you feel would be helpful in assessing the student's qualifications:

Characteristics / Outstanding / Excellent / Good / Average / Below Average
Commitment to schoolwork
Curiosity
Creativity
Hard working
Perseverance
Ability to adapt to new situations
Interpersonal skills
Analytical problem solving
Scientific / Math knowledge

Other Comments:

______

______

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Signature of EvaluatorDate

Application Deadline: April 30, 2014 4:00pm

Media Permission Form

University of Texas-Pan American STEM Camp

Student Name: (Please Print) ______

Session Attended

  • August 3rd – 8th

_____ I hereby grant permission to use my child’s name, picture and comments in materials (television, video, world-wide web, audio and printed media) used to promote the STPA Rising 8th-Graders Camp.

_____ I do not give such permission.

______

Parent/Guardian SignatureDate

Please sign and return to Daniel Rodriguez at STPA.

If you have questions regarding this form, please contact STISD Public Relations & Marketing Coordinator Amanda Odom at (956) 514-4255.