apply

The following form is a preliminary application form for The NET STEM and Mentoring programs. Once this is completed, a  member of our team will contact you with the full application. 

 

Please complete the preliminary application form below

Student Name *
Student Name
Student Home Phone
Student Home Phone
Student Cell Phone
Student Cell Phone
*Format: mmddyyy
Note: Student grades will not be used as a metric to determine acceptance into program
Parent Phone *
Parent Phone