Event Address: Online Event
Contact us at greatminds@dfwatw.org

Please fill out all fields in the below application. Only completed applications including essay will be submitted for consideration

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* 1. Student Name

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* 2. Email address

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* 3. Date Of Birth

Date

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* 4. Home Address

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* 5. School Name

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* 6. What grade is your child in?

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* 7. What is your GPA?

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* 8. List any honor societies you belong to (national honor society, etc)

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* 9. Details of extracurricular activity (sports) ?

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* 10. Work experience (Do you work part time job outside of school ?)

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* 11. Community Service (which organization you are involved / volunteer in your community, please describe)

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* 12. Please describe why do you want to participate in the iLead in STEM Program ?

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* 13. Parent Full Name

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* 14. Total Household Size

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* 15. Total Household Income

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* 16. I certify that the information on this form is true, accurate and complete to the best of my knowledge. I am responsible for notifying iLead in STEM program in writing of any changes in the information supplied in this application that might affect my students scholarship eligibility

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