First Light Saturday Science School --- Spring 2013 Registration is NOW OPEN! Register by April 1, 2013

Session III. Commences April 13, 2013

Who is eligible: DC residents in Grades 6, 7, and 8. Preference is given to student attending DCPS and Public Charter Schools. Acceptance is on a first-come basis. Register for the Spring Session NOW (registration closes April 1).

When: Sessions run for 6 Saturdays 1-4 PM (First day starts at 12:30 PM)

Session I: September 22, 29; October 13, 20, 27; November 3
Session II: January 12, 26; February 2, 9, 23; March 2
Session III: April 13, 20, 27; May 4, 11, 18

Where: Carnegie Institution for Science 1530 P St. NW Washington, DC 20005

Important: Please print out and complete the Authorization Form and bring on the first day. All communications are via e-mail so please provide e-mail addresses that you check often.

Student Information

First Name: *

Last Name: *

Address: *

Apt. #:

City: *

State: *

Zip Code: *

Primary Contact Phone Number: *

Primary Contact E-mail Address: *

Current Science Teacher:

Current School: *

Current Grade: *

Gender: *

Female

Male

Date of Birth (M/D/YR): *

Parent/Guardian Information

Mother (Female/Primary Householder)

First Name:

Last Name:

Home Address:

Home Phone:

Cell Phone:

Office Phone:

e-mail Address:

Father (Male/Secondary Householder)

First Name:

Last Name:

Home Address:

Home Phone:

Cell Phone:

Office Phone:

e-mail Address:

Emergency Contact Information

Name:

e-mail:

Home Phone:

Office Phone:

Cell Phone:

Relationship:

Medical Contact

Physician/Health Service Name:

Physician/Health Service Phone No.:

Allergies or special medical condition:

Food restrictions:

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Attachment	Size
FirstLight-AUTHORIZATIONS-2011.doc	210.5 KB
Spring Schedule April 13-May 18 2013.docx	47.97 KB