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CURRENT SCHOOL | |
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FOCUS |
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STUDENT FIRST NAME | |
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STUDENT LAST NAME | |
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STUDENT ID (IF KNOWN) | |
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DATE OF BIRTH | |
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STREET ADDRESS | |
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APT # | |
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CITY | |
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ZIP CODE | |
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CURRENT GRADE | |
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HAS THE STUDENT EVER PARTICIPATED IN THE GEMS/GISE/STEM AFTER SCHOOL PROGRAM?
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IF SO, WHERE & WHEN? |
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DOES THE STUDENT CURRENTLY RECEIVE ACADEMIC SUPPORT SUCH AS SPEC ED, TITLE 1, ELL (HOME LANGUAGE), OR ADVANCED LEARNER?
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IF YES, PLEASE LIST SUPPORT SERVICES |
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GUARDIAN 1 FIRST NAME | |
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GUARDIAN 1 LAST NAME | |
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GUARDIAN 1 PHONE NUMBER 1 | |
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GUARDIAN 1 EMAIL | |
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GUARDIAN 2 FIRST NAME | |
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GUARDIAN 2 LAST NAME | |
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GUARDIAN 2 PHONE NUMBER 1 | |
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GUARDIAN 2 EMAIL | |
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Project Based Learning Math (Gr K-1) | |
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Hmong Culture-STEM Course (Gr K-2) | |
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Coding-Engineering (Gr K-3) | |
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Simple Machines and Mechanisms (Gr K-3) | |
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STEM Explorer (Gr K-3) | |
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Story Starters (Gr K-3) | |
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American Indian STEAM Immersive Experience (Gr K-5) | |
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Energy Explorations (Gr K-5) | |
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KoolFit-2four7 (Gr K-5) | |
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Latin American Studies (Gr K-5) | |
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STEM Stories (Gr K-5) | |
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Project Based Learning Math (Gr 2-3) | |
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Camp Invention (Gr 3-5) | |
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Hmong Culture-STEM Course (Gr 3-5) | |
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Roller Coaster Science (Gr 3-5) | |
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Biomedical (Gr 4-5) | |
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Design Technology (Gr 4-5) | |
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ElectroWorks & Electronics (Gr 4-5) | |
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Explore Robotics (Gr 4-5) | |
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Natural Systems (Gr 4-5) | |
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Project Based Learning Math (Gr 4-5) | |
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STEM Creator (Gr 4-5) | |
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Architectural Design (Gr 6-8) | |
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Design Technology (Gr 6-8) | |
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ElectroWorks & Electronics (Gr 6-8) | |
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Explore Robotics (Gr 6-8) | |
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Invention Project (Gr 6-8) | |
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KoolFit-2four7 (Gr 6-8) | |
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Photography & Journalism (Gr 6-8) | |
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Roller Coaster Science (Gr 6-8) | |
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Sonic Pi Studio (Gr 6-8) | |
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STEM Innovator (Gr 6-8) | |
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Wind Turbines & ALT Energery (Gr 6-8) | |
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Parent/Guardian Goals for this Student | |
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Student Goals | |
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CITYWIDE SESSIONS |
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SCHOOL SPECIFIC SESSIONS |
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ATTENDANCE EXPECTATIONS AND PLEDGE OF COMMITMENT | |
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CONSENT | |
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STUDENT ELECTRONIC SIGNATURE | |
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PARENT/GUARDIAN ELECTRONIC SIGNATURE | |
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