York Elementary School (An Environmental STEM Community) is

offering an innovative and intense week (7 days) of Engineered 2 Learn

camp in the fall of the 2016-2017 school year for students who are
interested in science, technology, engineering, and math (S.T.E.M.).
The free program consists of seven one-hour lessons on engineering
concepts. The activities will incorporate highly engaging design challenges,
which integrate math and science strategies. Engineered 2 Learn will also
focus on career connections from NC State Universitys College of
Engineering. Collaboration will occur as students analyze project designs
and apply the steps of the design process as engineers do in their fields.
During the days students will be engaged with their design challenges but
will also have a mid-point snack break with provided snacks. Campus will
run from 3:45-5 pm. Tardiness for pick up will not be tolerated. Please
return completed forms to Ms. Osterhoff through teacher, front office,
or email: mosterhoff@wcpss.net
This packet includes the following:
- Participant Application Form
- Student Personal Statement
- Only 15 campers per topic will be selected. (Applications are based on a
lottery system if more than 15 campers apply per camp.)
- You must be able to provide transportation in the evenings for your
child. (Club will go 4 days the first week, 3 days the following week)
- Only completed applications will be reviewed for acceptance

Engineered 2 Learn 2015-2016

Participant Application Form
Student Name*:
Gender: Male / Female

Date of Birth*:________________________
Classroom Teacher: _________________________________

Home Address*:_______________________________________________________________________________
Email Address*:_______________________________________________________________________________
Racial/Ethnic Heritage (Choose one)
African American / Black
Native American
Hispanic / Latino
Asian
White / Caucasian
Other
In case of emergency we must be able to contact you.
Parents or Legal Guardians Name(s)*:

Phone Number(s)*:

________________________________________________

(__ ___ ___) _________--_________________

Parents or Legal Guardians Email Address*:

______________________________________________________________________________
Alternate Emergency Contact for child (Include name and phone number)*:

Please choose your preferred date*: (Tentative Dates a confirmation will come later.)
Fall Camp Topics:

Little Bits Circuits

or

Snap Circuits

The seven days selected for camp will run Monday Thursday the first week and then
Monday Wednesday the following week. (Late October Early November)
Parents are responsible for transportation to and from the camp. In the event you are unable to
pick up your child please list up to two individuals who have permission to pick up your child:
1) ________________________________________________________________________
2) ______________________________________________________________________
* = Required Information: Application will not be complete without these questions answered.

Student Personal Statement

In a paragraph, please explain why you would like to attend the Engineered
2 Learn camp. Include any interest you have in studying a Science,
Technology, Engineering, and/or Math related field. What types of things
would you like to learn while at camp? Please write legibly. (**Parent
written responses will not be taken into consideration.)