Student Name (First and Last Name)
Street Address
Zip Code
Student Cell Phone #
Student Email Address
Date of Birth (MM/DD/YYYY)
Student #
Grade Level Next School Year (Choose One)
Gender (Choose One)
High School Name
Parent(s) Name(s)
Parent Cell Phone #
Parent Email Address
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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