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Ultimate Technology Summer Camp Application

Ultimate Technology Summer Camp Application

Your Information

Last Name

First Name

Middle Initial

Street Address




Zip Code

Date of Birth


Ethnic Group

Parent Phone Number

Parent Email Address

Student Email Address

What school did you attend?

Anticipated grade in 2019-2020 school year (starting in the fall) 

Upload school transcript:  

Max size 2MB, allowed filetypes: PDF, DOC, DOCX    

Essay Question


What do you like most about STEM (Science, Technology, Engineering, and Mathematics) and why do you want to attend this camp? (500 word max)

Program Options


Which session are you interested in attending? (If willing to do either, please check both)

 June 3 - 6, 2019 June 10 - 13, 2019



 I understand that I must be selected to participate in this program. Submitting this application DOES NOT guarantee acceptance to the program.

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