Minecraft at the Museum Registration

Applicant Information

This is the application for 8-12 grade students for the Minecraft at the Museum program.

Application deadline is Tuesday, October 1, 2013, 5PM. However, the program can close earlier if all spots are filled.

Program dates:
25 session program: Tuesdays and Thursdays
Time: 4:30 am - 6:30 pm
Oct 15, 17, 22, 24, 29, Nov 5 (Election Day special time), 7, 12, 14, 19, 21, 26, Dec 3, 5, 10, 12, 17, 19, Jan 2, 7, 9, 14, 16, 21, 23

Please also note that your application is not complete until this entire form is completed. The program will cost $1,100 ($1,050 for members). FULL fee waivers are available for this program and requests can be made through this form.

Students will be notified of acceptance/rejection via email by October 4th, the latest. Students will also receive a letter, mailed out no later than the week of October 7.

(If you want to review details about the program before applying, please go here: http://www.amnh.org/learn-teach/grades-9-12/minecraft-at-the-museum, or direct questions to Barry Joseph at digitallearningatamnh@gmail.com)

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* 1. Applicant Name

First Name

Last Name

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* 2. Applicant Date of Birth (MM/DD/YYYY)

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* 3. Applicant Gender

Male

Female

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* 4. Language(s) spoken at home

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* 5. Applicant Contact Information
Please enter only information that pertains to the applicant in this section.

Street Address

Apartment Number

City

State

Zip Code

Home Phone (xxx-xxx-xxxx)

Cell Phone (xxx-xxx-xxxx)

E-mail Address

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* 6. With whom does the applicant live?

Parent

Legal Guardian

Other

If other, please explain

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* 7. Might you request a full fee waiver?

Yes

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* 1. Applicant Name

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* 2. Applicant Date of Birth (MM/DD/YYYY)

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* 3. Applicant Gender

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* 4. Language(s) spoken at home

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* 5. Applicant Contact InformationPlease enter only information that pertains to the applicant in this section.

Question Title

* 6. With whom does the applicant live?

Question Title

* 7. Might you request a full fee waiver?

* 5. Applicant Contact Information
Please enter only information that pertains to the applicant in this section.