Connect Center Scholarships

Summer of STEAM for every child

Student Information

Student Full Name

Date of Birth

Month

Day

Year

Current Grade

Grade Next Fall

Parent/ Guardian Full Name

Email

Phone

Preferred Enrollment Type

Full Program (6 weeks)

Weekly Enrollment

Household & Financial Need

Household size (number of people)

Do you receive public assistance (e.g., free/reduced lunch, SNAP)?

Yes

No

Prefer not to answer

Interest & Program Fit

Why are you excited about Summer of STEAM? What do you hope to learn or create?

Any prior STEAM experience or activities?

How would attending help your school goals or future interests?

Community & Verification

Teacher/coach name (for brief confirmation only)

Phone

I confirm the information is accurate and consent to contact for follow-up

Award Preferences & Commitment

Requested Support

Full Scholarship

Partial Scholarship

Agreement

I confirm this information is accurate

I understand scholarships are limited

If awarded, I commit to consistent attendance

Signature

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