Student First Name*
Student Last Name*
Street Address*
Zip Code*
Student Cell Phone #
Student School Email Address*
Student Personal Email Address*
Date of Birth (MM/DD/YYYY)*
Student #
Grade Level Next School Year (Choose One)*
Gender (Choose One)
High School You Attend*
Parent(s) Name(s)*
Parent Cell Phone #*
Parent Email Address 1*
Parent Email Address 2
STL CAPS Course Selection (Choose One)*
Session Preference (Choose One)
Question #1: What activities, courses, experiences or previous learning stimulated your interest in STL CAPS?*
Question #2: What ideas or plans do you have for your future career?*
Question #3: Please include a personal statement on what you hope to gain from the STL CAPS program and what you have to offer the program?*

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