2025 Stemersion Application 2025 STEMersion ApplicationPlease complete the form below. Select Today's Date* Name* What is your title?* Email* Phone Number* Home Address* What is your current school district?*---BerkeleyCharlestonDorchester 2Dorchester 4Private What school do you represent?* What grade(s) do you represent?*---Pre-SchoolElementaryMiddle SchoolHigh School2-Year College4-Year College What course/area is your primary focus?* Does your school identify as a Title 1 School?YesNo I commit to attend the full 2025 STEMersion session, June 9th through June 13, 2025.YesNo I understand daily stipends are dependent on full participation and completion of all assignments.YesNo I understand group participation and completion of a group project may require working outside of STEMersion hours.YesNo In your subject area, list the top three course/ curriculum topics that students struggle to grasp.* How are you currently using Project Based Learning (PBL) and/ or Engineering Design Process (EDP)?* What are your expectations during STEMersion?* During the 2025 - 2026 academic year, I can reach approximately _____ students with the information shared during STEMersion.* List any dietary restrictions you may have. List any environmental restrictions you may have. Please list the name of the school district administrator (Superintendent, Director, Principal, etc.) who recommends you for STEMersion 2025.* Have you participated in STEMersion before? If so, please list the years. If you have participated in STEMersion previously, are you applying to return as an “Ambassador” for 2025? YesNo If you are applying to be an Ambassador, please provide a summary of your understanding of the Ambassador role and how you feel you fit best and can contribute to this role. (If you are not applying as an ambassador leave blank) Tri-County STEMersion consists of a rigorous 5-day experience, requiring sitting or standing for long periods of time, ascending and descending stairs, and walking long distances while moving safely over uneven terrain. In certain cases participants must be able to wear protective gear and respond quickly to loud sounds. I confirm I can meet these requirements and will discuss any accommodations needed with planning team. YesNo Are you available to participate in follow-up STEMersion activities and mid-year reporting? *---YesNoMaybe By submitting this form, I understand a reduced stipend will be offered based on absences and/lack of participation in Tri-County STEMersion 2025. *---Yes, I agreeNo, I do not agree Comments