Explore Mars Academy: Apply

Student Information

Student's name *

First

Last

Student's email *

Email

Confirm Email

Gender *

Male
Female
Do not wish to report

Please describe the student's race or ethnicity: *

Student's age *

Which state do you reside in? *

Oregon
Washington

What grade will the student be entering next fall? *

9th grade
10th grade
Other

What school will the student be entering next fall? *

What is the student's T-shirt size? *

In 75 words or less, please tell us about your interest in science, technology, engineering, or math:

Are you currently part of a college preparatory program such as GEAR-UP, MESA, or Upward Bound? If yes, which one(s)?

Parent/Guardian Information

Parent/Guardian's name *

First

Last

Please specify relationship to student: *

Parent/Guardian's cell or day phone *

Parent/Guardian's email *

Email

Confirm Email

Parent/Guardian's mailing address *

Address Line 1

Address Line 2

City

State

Zip Code

We may have a few more questions regarding your application. Are you willing to chat on the phone with the program manager Deanna Marshall as a part of the application process?

Yes
No

If yes, what is the best phone number to reach you?

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Explore Mars Academy: Apply

Student Information

Parent/Guardian Information

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