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B2-CARS Middle School Student Application Form

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Student Name *
Permanent Address *
What grade will you be in when the school year starts (August 2025)? *
What is your gender? *
What is your ethnicity? (Select all that may apply) *
Rank: Strongly disagree, disagree, agree or strongly agree *
Strongly disagreeDisagreeAgreeStrongly agree
Learning science is interesting *
Learning science will help me get a job *
I spend a lot of time learning science *
Knowing science will benefit me in my future *
My favorite subject is math *
My favorite subject is science *
Does your future career involve science, technology, engineering and/or math? *
After high school, do you plan to attend college? *
In college, do you plan to pursue science, technology, engineering or math as a major? *
What is your t-shirt size? (adult sizes) *

*Please send letter of recommendation from a teacher (past or present) or mentor describing your academic work ethic and interest in science (optional).

Email letter to: csudler [at] desu.edu

Subject: Applicant Name_Recommendation

Questions for parent/guardian only:

Parent/Guardian Name *
Parent/Guardian Permanent Address *
In which Cohort would you prefer your child/children to participate? *
Do you have access to internet? *
Which social media platform(s) do you allow your child/children to utilize? Select all that apply. *
What is your total household income? *
What is the highest degree or level of education you have completed? *
What is your current employment status? *