Young STEAM Visionaries
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Student Inquiry Form
Take the first step towards academic excellence
Student Information
Student Name*
Parent/Guardian Name*
Contact Information
Email Address*
Phone Number*
Academic Information
Current School*
Grade Level*
Select Grade
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Please Fill Out The Following Information
Child's Age*
Which Program Would You Like Your Child To Participate In?*
1st Group (Ages 5-7): Introduction to STEAM through interactive play and basic concepts
2nd Group (Ages 8-10): Hands-on STEAM activities and fundamental principles
3rd Group (Ages 11-12): Advanced STEAM concepts and project-based learning
Would you like reoccuring sessions or a one time session to see what it's like? (please note you always change by emailing us)*
One Time Session
Reoccuring
Areas of Interest*
Schedule Preference
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Monday
After School Hours (3PM - 7PM)
3:00 PM
4:00 PM
5:00 PM
6:00 PM
7:00 PM
Morning (9AM - 12PM)
9:00 AM
10:00 AM
11:00 AM
Afternoon (12PM - 3PM)
12:00 PM
1:00 PM
2:00 PM
3:00 PM
Evening (4PM - 7PM)
4:00 PM
5:00 PM
6:00 PM
7:00 PM
Additional Information
Previous STEAM Experience
Learning Style and Preferences*
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