2019 ExciTES Application

Exit Survey
Questions marked with a * are required
100%
Participant Contact Information
Parent/Guardian Contact Information
Participant's Interest (Select all that apply)
Engineers are creative problem solvers. They have a vision for how something should work and are dedicated to making it better, faster, or more efficient. ( If you think the statement is correct select true if not select false)
Engineers create opportunities. They help shape the future. They use their communication skills, the latest in science and technology to bring ideas to life. ( If you think the statement is correct select true if not select false)
What do you think is your greatest strength?
What makes you a unique individual to work with?
What difference will you make in this world by the time you are 30 years old?
Participant's Academic Reference
Share the contact information of a reference who can speak on behalf of your academic or professional performance.
Reference can be a teacher, counselor, or someone at your school, but should not be a family member or friend.
First Name
Last Name
Organization/School
Title of Position:
Phone Number:
Participant's Personal Reference
Share contact information of a reference who can write about your aspirations or dreams and your ability to work in a team. Reference could be a neighbor, a coach, a teacher, or almost anybody who may be contacted to share what they think your aspirations are and how you contribute as a team member.
First Name
Last Name
Organization/School
Title of Position:
Email Address:
Participant's Demographic Information Gender
Ethnicity:
Primary Language Spoken at Home
Participant's Education
Name the school you are
1) currently enrolled at
2) the school you plan to be enrolled in this coming fall and
3) the high school you expect to graduate from 
Current School:
School in Fall:
Expected High School:
Current School:
School in Fall:
Expected High School:
School District:
Expected High School Graduation year
What is your shirt size?
Grade Level You Will Be In This Coming Fall 
Based on the grade level selected, you are eligible to apply to one of the following:
2019 ExciTES Sessions. These Sessions are intended for rising 6th – 8th graders.  If selected, the cost is $175 per student per week.  These all-day Sessions run Monday - Friday, 9:00am - 4:00pm.
2019 Sol Y Agua Coding for Girls. These Sessions are intended for rising 6th – 8th grade girls.  If selected, the cost is $175 per student per week. These all-day Sessions run Monday - Friday, 9:00 am - 4:00 pm.
2019 Challenge Sessions. These Sessions are intended for rising 9th – 11th graders.  If selected, the cost is $175 per student per week. These all-day Sessions run Monday - Friday, 9:00am - 4:00 pm.
How did you hear about ExciTES?
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