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STEM Registration

STEM

Date: June 10th - 14th, 2024

Description: 3rd - 8th Grade, Get STEM Education Now!

Contact: Sherri Pebbles at 307-864-6551

Parent/Guardian First Name*

Answer Required

Parent/Guardian Last Name*

Answer Required

Parent/Guardian Phone Number*

Number Required

Student First Name*

Answer Required

Student Last Name*

Answer Required

Student Age*

Answer Required

Student Grade*

Answer Required

Student Medical Concerns

Answer Required

Student Lunch*

Answer Required

Student will provide

STEM will provide

Select Your Top 2 Class Choices

your student will be placed in one of these 2 classes

Class Choice #1*

Answer Required

Class Choice #2*

must be different than above

Answer Required

Parent/Guardian Signature*

Signature Required

Confirmation Email

Confirmation Email *

Email Required