Future Women in STEAM Summer Academy Application

The Future Women in STEAM (Science, Technology, Engineer, Art, and Math) Summer Academy is a four‑day, interactive enrichment program designed to empower young women in grades 8–10 to explore and pursue pathways in science, technology, engineering, and mathematics while understanding the connection with art. By providing hands‑on experiences, mentorship, and exposure to real-world STEAM applications, the camp aims to address the persistent underrepresentation of women in STEAM fields and inspire the next generation of innovators.

This program will integrate the mission and resources of CSTEP, highlight women leaders in STEAM, and create a supportive environment where students can build confidence, curiosity, and community.

Dates: July 27–30
Time: 8:00 AM – 12:00 PM, Drop Off 8-8:30, pickup 11:30-12:00PM
Capacity: 20 Students
Cost: Free- High School Counselor recommendation required
Includes: Daily Breakfast and Camp T‑Shirt
Deadline: June 15 –Selection by July 1

Student Information

First Name

Preferred First Name

Last Name

Pronouns (Optional)

Birthdate

Email Address

Parent/Guardian Email

Parent/Guardian Name

Parent/Guardian Phone

Home Phone Number

Cell Phone Number

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Mailing Address

Country

Street

City

Region

Postal Code

School Information

High School Name

HS Graduation Year

Student Registration Form

Application Type:

Registration Term:

What interests you about STEAM (Science, Technology, Engineering, Art and Math)?

Which STEAM area are you most excited to learn about (engineering, math, chemistry, art, or computer programming) and why?

Describe a time you solved a problem, created something, or figured something out on your own. What did you learn from it?

T-shirt Size

Please list any food restrictions or other allergies. Put "N/A" if there are none.

Student Commitment

By applying, I understand that:

The camp runs July 27–30 from 8:30–11:30 AM (drop off 8:00-8:30, pickup 11:30-12:00)
Breakfast and a t‑shirt will be provided
Participation is interactive and hands‑on
Space is limited to 20 students
Parent permission is required
Counselor recommendation is required
Students will be notified of their selection or denial by mailed letter

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Parent/Guardian Permission Statement

Please upload a written statement and signature from parent/guardian stating the following:
I give permission for my child to participate in the Women in STEAM Summer Camp and understand that the program includes hands‑on STEM activities, supervised outdoor time, and guest speakers. I understand that pickup and drop off protocols will need to be followed and a brief initial parent orientation will be held during the morning on the camp day 1. Furthermore, I give Jefferson Community College permission to use photos of my student for promotional purposes on the college’s social media platforms, website, and promotional materials. I understand that:

By applying, I understand that:

The camp runs July 27–30 from 8:30–11:30 AM (drop off 8:00-8:30, pickup 11:30-12:00)
Breakfast and a t‑shirt will be provided
Participation is interactive and hands‑on
Space is limited to 20 students
Parent permission is required
Counselor recommendation is required
Students will be notified of their selection or denial by mailed letter

Or, type or copy-and-paste your document here:

Counselor/Teacher Referral

A referral is required to complete the student’s application. This form should be filled out by a school counselor, teacher, or other school professional who knows the student’s academic strengths, interests, or potential.

Referral Questions

(Please answer in 2–4 sentences each.)

1. How long and in what capacity have you known this student?

2. What strengths does this student demonstrate that make them a good fit for a STEAM‑focused program?

Referrer Name

Role/Title

High School Name

Phone

Jefferson Community College Website

Future Women in STEAM Summer Academy Application