Student-Athlete STEM Academy Registration Age group of something here 2021 Virtual Student Athlete STEM Academy (SASA) Registration – NEW! HS 9-12 Grade Student InformationStudent Name * Required First Middle Last Date of Birth * Required MM DD YYYY Student Gender * RequiredFemaleMaleRace and Ethnicity * RequiredPlease check all that apply. This is for statistical purposes only. African American American Indian or Alaska Native Asian American Caucasian or European American Hispanic/Latino Pacific Islander or Hawaiian Native Nation/Country of OriginThis is for statistical purposes only.Student Cell Phone * RequiredStudent Email * Required Permanent Mailing Address * Required Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Parent/Guardian InformationParent Name * Required First Last Relation to Student * RequiredParent Phone * RequiredParent Email * Required Emergency ContactEmergency Contact Name * Required First Last Relation to Student * RequiredEmergency Contact Phone * RequiredEducational BackgroundCurrent Grade Level * RequiredFor the current (2020-2021) school year.9th grade10th grade11th grade12th gradeCurrent GPA * RequiredInclude two digits after the decimal point. Do not round-up a GPA, for example, a GPA of 3.709 is 3.70 with 2 decimals and NOT 3.71. High School Name * RequiredPlease fill out the complete school name.High School Location * Required City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific What sports do you currently participate in?ACT/SAT InformationPrevious Testing Experience * RequiredHave you taken the real ACT/SAT before? (The one you sit at a testing center for 4-5 hours on a Saturday and with a maximum score of 36 for the ACT or 1600 for the SAT)ACT onlySAT onlyBoth ACT and SATNeverCollege Admissions Test Information * Required 1. If you have had taken the real ACT before, please include the following date and scores for every ACT that you have taken: "MM/YYYY, Composite: English/Math/Reading/Science (Writing)"; for example, "06/2016, 25: 23/27/26/24 (9)" 2. If you have taken the real SAT before, please include the following date and scores: "MM/YYYY, Critical Reading/Math (Writing)"; for example: "09/2016 660/690 (670)"ACT: MM/YYYY, CC: EE/MM/RR/SS (W) SAT: MM/YYYY READ/MATH (WRIT)Student ExperiencesExtracurricular Activities and Shadowing * RequiredPlease list your activities outside of the classroom and experiences shadowing professionals, if any. Briefly explain if necessary.Awards, Honors, and RecognitionsPlease list the awards, honors, and recognition that you have received. Briefly explain if necessary.Past Experience with Division for Diversity Equity and Inclusion (formerly known as Center for Diversity Affairs CDA).If you have participated in any programs or events with Division for Diversity Equity and Inclusion in the past. Please list them here and include the year, for example, “HPREP Conference 2019”Personal Statement * RequiredWithin 300 words, 1. What career would you like to know more about, and why? How can you learn about it? Additional Student InformationFirst-choice Career * RequiredWhat is your number one choice of career right now?Second-choice Career * RequiredWhat is your backup career of choice?Third-choice Career * RequiredIf both of the above didn't work out, what would you choose for your career?Eligibility * RequiredTo be eligible for participation in this program students must first be classified as a student athlete you must meet one (1) or more of the following three (3) criteria (please refer to the application instruction for details): Educational disadvantage Economic disadvantage Underrepresented minority Photo * RequiredPlease upload a professional photo of the student.Accepted file types: jpg, jpeg, gif, png.Résumé(Optional) Please upload your résumé if you have one. This would help us in the selection process.Accepted file types: doc, docx, pdf.ReferencesUpon submission of this application, an automated email will be sent to your reference at the address you provide here. The email will give your reference instructions for submitting a letter of recommendation. We recommend two references but one references will work for SASA.Reference #1 Name * Required First Last Reference #1 Title * RequiredReference #1 Email * Required Reference #2 Name (Optional) First Last Reference #2 TitleReference #2 Email ConfirmationBy clicking "Submit", you agree that: 1. Both the student and parent(s) have read the program description and agreed to its content and rules, and 2. The information provided in this application is both complete and accurate.
