Premier
Mechatronics-Robotics
Academy Registration
2017-18

 
PARTICIPANT INFORMATION
Last Name * (* indicates required field)
First Name *
Male/Female *
Current Grade * (must currently be in grade 8-11)
Birthdate * (Month/dd/yyyy) (ie: May/19/2002)
PRIMARY PARENT CONTACT INFORMATION
Primary Parent Contact Name *
Primary Contact Telephone *
Primary Contact Email *
Primary Contact Home Phone
Primary Contact Work Phone
Primary Contact Cell Phone
Address *
City *
Postal Code *
OTHER PARENT CONTACT INFORMATION
Other Parent Contact Name
Other Parent Contact Telephone
Other Parent Contact Email
Other Parent Contact Home Phone
Other Parent Contact Work Phone
Other Parent Contact Cell Phone
Address If different from above
City
Postal Code
ADDITIONAL INFORMATION
Student's Current School *
School Location * ie: West Vancouver, North Vancouver, etc.
School Attending this September *
Please submit the following information via .pdf .doc or. rtf.
(use the "Browse" button to attach the file from your computer
)

1. Tell us what you hope to accomplish by participating in the Premier Mechatronics Robotics Academy.
2. Achievements over the past three years. (Tell us about some of your experiences in this area (if any) and any other area you have been participating – sports, music, academic, etc.
3. A statement indicating why you would be a good candidate for the Premier Mechatronics Robotics Academy.
4. Please scan or provide a copy of the most recent report card to dnelson@wvschools.ca.

* Attach document here:

Please click "Submit Registration" button only ONCE and wait...