MSR SATURDAY SCIENCE WORKSHOP

MOTHER SETON REGIONAL HIGH SCHOOL
ONE VALLEY ROAD, CLARK, NEW JERSEY 07066
(732) 382-1952 - FAX (732) 382-4725
APPLICATION

SATURDAY, OCTOBER 18, 2008
8:30 -11:30 a.m.

NAME _________________________________________ GRADE _____________________
(Please Print)
HOME ADDRESS ____________________________________________________________
TOWN ______________________________STATE ________ ZIP CODE________
HOME PHONE NUMBER _______________________________
SCHOOL _________________________________TOWN ________________________

Please indicate in which subject areas you would prefer to work by placing
1 next to your first choice, 2 next to your second choice, and 3 by your third choice.

________ Chemistry ________ Biology ________Physics


You will be placed in two subject areas according to your preferences, on a first respond, first served process.

Write a paragraph explaining why you would like to participate in this workshop. Use the back of this form.

___________________________________________
Student's Signature

___________________________________________
Parent's Signature


Please complete the above application form and return it with $10.00
(check or money order only)
to the following address
no later than Friday, October 10, 2008.

Saturday Science Workshop
Mother Seton Regional High School
One Valley Road Clark, NJ 07066

Enrollment in the workshop is limited and will be determined on a first-come, first-served basis, so please complete the application and send it in as soon as possible. You will be informed no later than Tuesday, October 14th of your acceptance into the program.
.