2026 Stemersion Application

Select Today's Date*

Name*

Job Title?*

Email*

Phone Number*

Home Address*

What is your current school district?*

What school do you represent?*

What grade(s) do you represent?*

What course/area is your primary focus?*

Does your school identify as a Title 1 School?YesNo

I commit to attend the full 2026 STEMersion session, June 8th through June 12th, 2026.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 2026 - 2027 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 2026.*

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? *

By submitting this form, I understand a reduced stipend will be offered based on absences and/lack of participation in Tri-County STEMersion 2026. *

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