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CZsUkaPrRi2ARx2sSQbdNiB4SMjrUsKa2EHcK93viC3cFG3Cg6uzWwQPBC6XwEieVmMqhoNtmr66xZcWaLjvKZVGemfmErwmaSbY

POWER-IT Summer Camp 2021

Returning?

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Preparing Outstanding Women for Engineering Roles and Information Technology (POWER-IT) Summer Camp! This summer day camp will be held on the Indiana University-Purdue University Indianapolis (IUPUI) campus July 13-17, 2020.

Explore engineering and technology with young women your age at the Power-It Summer Camp. Participants will have hands-on opportunities to learn if engineering or technology is for you.

Receipt of payment will hold your spot. The program fee is $75, which covers the cost of a cinch bag, t-shirt, supplies, lunch, snacks, and activities.

Contact etinfo@iupui.edu or 317-274-2533, if you have any questions.

Student First Name:

* must provide value

Student Last Name:

* must provide value

Email Address:

* must provide value

Street Address:

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City:

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State:

* must provide value

Zip Code:

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Primary Phone:

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Alternate Phone:

Date of Birth:

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M-D-Y

Racial/Ethnic Heritage
(check all that apply)

African American/Black

Hispanic/Latino

White/Non-Hispanic

Asian

American Indian/Alaskan Native

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Vegetarian Meal Required

* must provide value

Yes

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T-Shirt size

* must provide value

S-Small

M-Medium

L-Large

XL-Extra Large

XXL-Extra, Extra Large

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Do you qualify for free or reduced lunch?

* must provide value

Yes

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Would you be the first in your immediate family to attend a college or university?

* must provide value

Yes

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Are you a 21st Century Scholar?

* must provide value

Yes

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Name of High School:

* must provide value

Grade Entering in Fall 2020

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If attending college fall 2020, what is the name of the school you will be attending?

Parent/Guardian First Name:

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Parent/Guardian Last Name:

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Parent/Guardian Email Address:

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Emergency Contact Name:

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Emergency Contact Phone:

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1. Why are you interested in learning more about engineering and technology?

* must provide value

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2. List any math and science courses and grades received.

* must provide value

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3. Have you taken Project Lead the Way classes? If yes, please list the classes.

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