Fillable SEE Application 2016 Fresno Summer Engineering

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SEE Application 2016 Fresno Summer Engineering

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Summer Engineering Experience 2016
Lyles College of Engineering
Jun
e 27 – July 1, 2016
The Summer Engineering Experience is a five-day, non-residential program held June 27 - July 1,
2016 at Fresno State. The mission of the program is to educate young students, entering grades
10, 11, and 12 in Fall 2016, on the benefits and varied aspects of a profession in
engineering. The program focuses on hands-on activities combined with academic lectures that
cover engineering topics such as Geomatics, Construction Management, Robotics, and
Electronics. In addition to engineering activities, the camp will provide several physical and
recreational activities designed to increase leadership skills, gain confidence and experience in a
technical environment.
Sessions run from 8:30 a.m. to 4 p.m. each day. Daily attendance is required. Lunch, snacks,
educational materials
, and field trip transportation are included.
Cost of the program is $150. Sc
holarships are available to qualified students. Space is limited.
Applications are accepted through Friday, April 22, 2016
Application Requirements:
• Completion of the attached application.
• A one page personal statement written by the student that expresses their passion for science
and/or mathematics.
o If the student is requesting a scholarship, include a statement of need in the personal statement
and proof of qualifying for free or reduced lunch.
• A letter of recommendation from a current teacher (teacher may submit directly to
lcoepathways@csufresno.edu or mail paper copy to the address below).
• Current Transcripts (Unofficial or Official)
• Please submit ALL documents as an attachment to lcoepathways@csufresno.edu
This is a non-residential program. Transportation to and from the program is the responsibility of
the parents and/or guardians. In order to be considered, students must complete and submit a
complete application by the deadline: April 22, 2016.
Questions, please call or e-mail:
Ly
les College of Engineering
Pathways, Student Services
Phone: 559-278-8242
Fax: 559-278-4517
e-mail: hernanm@csufresno.edu
Application Deadline: April 22, 2016.
Fresno State
Summer Engineering Experience
2320 Eas
t San Ramon Avenue, M/S EE94
Fresno, California 93740-8028.
1
2016 Summer Engineering Experience
Program/Field Study Permission & Student Checkout
Program Participation and Field Study-travel Permission:
I agree to allow my child to participate in the Summer Engineering Experience (SEE), June 27
th
– July 1
st
2016, and
attend any educational study trips scheduled throughout the camp. I understand that program rules and regulations
apply at all times, including study trips and that transportation will be provided for all study trips by SEE.
Student Personal Information:
Student Name: ______ Birth date:
S
chool Attending: ______________________________ Current Grade (Fall 2016): _________
Las
t Math Completed:
Geometry
Algebra 1
Algebra 2
Advanced Math
Calculus AB
Calculus BC
Statistics
Parent/Guardian Name:
Address:
Street City Zip
Home Telephone: Message Phone: E-mail Address:_____________
If applying for a scholarship, please indicate whether you are eligible for free or reduced lunch at your school.
Please provide proof. Check One: Yes No
O
ther person to contact in case of an emergency:
Name: Relationship:
Phone: __________________________ Phone #2: _________________________________
Family Doctor: Doctor’s Telephone:
Allergic to medication: Current Medication(s):
Student Pick-Up Authorization
In any event that my child should need to leave CSUF during camp program hours, and I cannot be contacted, the
individual/s listed below have my authorization to pick him/her up in my place.
Name
Relation
Contact Number
Please note: If your son or daughter is checking out with someone other than a parent/guardian a valid
identification will be required.
A
GREEMENT: I understand that pictures may be taken of program events and activities for the purposes of publicity
and public relations. I further give my permission of any likeness of me or my child captured on these pictures to be
used, as the program deems necessary.
A
GREEMENT: By signing this Electronic Signature Acknowledgment Form, I agree that my electronic signature is the
legally binding equivalent to my handwritten signature. Whenever I execute an electronic signature, it has the same
validity and meaning as my handwritten signature. I will not, at any time in the future, repudiate the meaning of my
electronic signature or claim that my electronic signature is not legally binding. By signing below, I accept the
conditions of this agreement.
Parent/Guardian Signature Date:
2
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SEE Application 2016 Fresno Summer Engineering

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Completed 19 June 2020

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