GEMS at Russell Sage College

Student Registration Form
Name
School
Level	Middle School High School
Grade
Guidance Counselor
Home Address
City, State, Zip
Email
Phone 123-555-1234
Emergency Contact
Contact Number 123-555-1234
Engineering, Mathematics, and Computer Science courses you have taken or are currently taking
Are you currently enrolled in a Project Lead the Way (PLTW) course? Please Specify
Are you currently enrolled in the Project Lead the Way (PLTW) program?	Yes No
Please indicate preference for workshops you would like to attend 1 = Most Interested, etc.	Engineering Workshop Mathematics Workshop Computer Science Workshop
Every effort will be made, on a first-come, first-served basis, to accommodate preferences. Thursday March 25, 2010 at Sage College of Albany Middle School Engineering Workshop: Lemon Battery Challenge Mathematics Workshop: Eye Spy Computer Science Workshop: Microsoft Publisher High School Engineering Workshop: Pipeline Challenge Mathematics Workshop: Geometers' Sketchpad Computer Science Workshop: Advanced PowerPoint - Adding video and sound