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Project Determination Registration Form
Project Determination Registration Form
Registration Form
Project Determination offers students in 5th & 6th grades a fun, afterschool environment to
explore the world they live in by infusing visual arts, science, technology, engineering, and mathematics
(STEM) together. Students will participate in hands on science inquiry experiences, have opportunities to
showcase the projects that they create and discover their own aspirations. Project Determination will meet
for seven consecutive Mondays from 3:30pm to 6:00pm, with a culminating event on December 6, 2010.
Space is limited to 25 students. A waiting list will be maintained, and applicants are accepted from the waiting
list as space becomes available.
Ethnicity- This information is requested so we may report statistical data regarding our participants to the State of Illinois
and/or other program funders. Only aggregate date will be shared. Summaries will not contain individual information.
Please pick one or more from list below
Signature
Your signature indicates that you support your child’s full participation in Project Determination. You will also provide
arrangements to and from IMSA Chicago Field Office. Your signature gives permission for your child’s photograph to be
taken and used for educational and promotional purposes by IMSA.