Registration

Full Name(required)

Email(required)

Select a specific SPARK STEM™ Event, Program, Service, or Resource(required) 1 Day Workshop 1/2 Day Workshop 3 Day Bootcamp 5 Day Bootcamp TinySparkClassroom SPARK STEM Day Other

School Name, Student Name, or Community Name

Number of Students (if related to request)

Do you have an additional inquiry? If applicable… Teachers Corner Submission SPARK STEM 365 Event Request Cooler Mixer Mobile Classroom Request School Event Request Community Event Request Setup STEM Education Booth SPARK STEM Toolkit STEM Club Tiny SPARK Grant Coaching/Mentoring Request STEM-tastic Boot Camp Student Inquiry or Request Parent Release Waiver Co-Ed Flag Football Registration Girl Flag Football Registration Boys Flag Football Registration Volunteer Join PWS Network SPARK STEM Ambassador Club Member

Phone Number(required)

Who referred you? (Type N/A if do not apply)(required)

Parent Consent & Release Form Sent via Email(required)

Yes No

Comments NOTE: Please add each student name in the comments field separated by a comma. Thank you!

Submit

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Thank you for your registration and interest in the National STEM Society dba SPARK S.T.E.M™ brand programs or services. Please allow 48 hours for a response to your inquiry.