Exploring careers in Science and Engineering
Please fill in the following form and press the Submit button to register for Explorer Post 6201 projects.
Register for Post 6201 2011-2012 Projects
Explorer Personal Information
First Name
Middle Initial
Last Name
Suffix (Jr, III, etc)
Address Line 1
Address Line 2
Town/City
State
New York
Zip Code
(ie 12345)
Home Phone
(ie 3154566201)
Email Address
(so we can send a confirmation message)
Birth Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Birth Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Birth Year
1992
1993
1994
1995
1996
1997
Gender
Female
Male
Explorer School Information
School Name
Current Grade
9th
10th
11th
12th
12+
Explorer Emergency Contact Information
Emergency Contact Name
Emergency Contact Phone
(ie 3154566201)
Explorer Citizenship Information
US Citizen?
No
Yes
If US Citizen, Dual Citizenship?
No
Yes
If dual citizen, please enter nationalities.
If not US Citizen please enter nationalities .
If not US Citizen please enter immigration status.
Explorer Project Selection
First Choice:
None
Design It, Build It, Ship It (Wed)
Electronic Construction (Thurs)
Java (Tue)
Programming in Python (Tue)
Advanced Robotics (Tue)
Mindstorm Robotics (Wed)
Rube Goldberg (Tue)
Second Choice:
None
Design It, Build It, Ship It (Wed)
Electronic Construction (Thurs)
Java (Tue)
Programming in Python (Tue)
Advanced Robotics (Tue)
Mindstorm Robotics (Wed)
Rube Goldberg (Tue)
Third Choice:
None
Design It, Build It, Ship It (Wed)
Electronic Construction (Thurs)
Java (Tue)
Programming in Python (Tue)
Advanced Robotics (Tue)
Mindstorm Robotics (Wed)
Rube Goldberg (Tue)
Nights Not Available
(hold down Ctrl
to select multiple)
Monday
Tuesday
Wednesday
Thursday
Member last year?
No
Yes
Privacy Notice:
Please note that this information is transmitted to the server UNENCRYPTED. This means it is possible that someone could intercept this information (including your name and address) during transmission. If you are uncomfortable with this, please use the paper registration form.
