St. Louis CAPS Application
Student Name (First and Last Name)
Student Cell Phone #
Student Email Address
Date of Birth (MM/DD/YYYY)
Grade Level Next School Year (Choose One)
Gender (Choose One)
High School Name
Parent Cell Phone #
Parent Email Address
STL CAPS Course Selection (Choose One)
Healthcare, Medicine & Bioscience
Global Business & Entrepreneurship
Engineering & Advanced Manufacturing
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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December 21, 2016
Breakfast with Medical Professional Mentors