Summer Program Required Forms

COVID vaccination required: Acceptance into all programs require your student to be fully vaccinated (2 doses of Moderna, two doses of Pfizer or 1 dose of Johnson & Johnson). Please submit a copy of the student’s COVID vaccination card.

Evidence of other immunizations: Acceptance into all programs also requires your student to be fully immunized in accordance with the New York State Department of Health's standards. Proof of immunizations can be a physician’s immunization record with a physician’s office stamp. The physician’s office stamp is required by NYS Department of Health to authenticate the record. Please submit a copy of your student’s immunization record as provided by the student’s physician’s office.

These records must be submitted prior to the start of the program by our specified deadlines.

First Name^*

Last Name^*

Email^*

Program^*

Choose one Engineering Experience Women in Computer Science, Engineering and Technology (WiCET) Summer Program Middle School Maker Academy

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Covid Documents

Covid-19 Vaccination Card^*

Doctors Authorization Document^*

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Media Consent Forms

Please fill out and re-upload the following media consent forms

• Permission for Online Learning and Electronic Communication During the Public Health Emergency Form
• Media Consent Form
• Behavioral Conduct Consent Form

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Please enter the characters displayed in the image below.^*

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