Fall FAST

FUTURE ACHIEVERS IN
SCIENCE AND TECHNOLOGY

September 10 - 11, 2010

Name Female Male
Address
City _________________________ State Zip Code
Phone #: Home Mobile
Email
High School
HS City/State Zip Code
Age Year in High School Ethnicity (Optional)
Parent/Guardian Information:
Occupation ________________ Highest Degree Earned________________
Occupation ________________ Highest Degree Earned________________

Current Class Schedule

(Please indicate which courses are Honors, IB or AP)

First Semester Second Semester

Cumulative GPA _____ PSAT/SAT Scores CR____ M____ WR____

Plan/ACT Scores EN____ MA ____ RE____ SR____ CM_____

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Please include an unofficial copy of your high school transcript (9th- present)
and a resume highlighting your extracurricular achievements, positions held,
or honors received.

Please answer the following questions on a separate piece of paper (one

typed page maximum per question).
1. What sparked your interest in the science, technology, engineering, and
math fields?
2. What are you expecting to get out of your college experience?

Your application and all accompanying materials must be received by AUGUST 16th.

Signature Date

Parent/Guardian Date