Application

First Name

Last Name

Email Address

New York State Resident

Is the student a New York State resident?

Income Eligibility Criteria

Students who are not a member of a historically underrepresented group (as defined by the New York State Education Department): African American/Black, Latino/Hispanic or Native American/Alaskan Native must meet the NY State Education Dept Income Guidelines. Please attach a copy of most recent 1040 tax form, or school lunch form application, or parents' paystub here (Social Security numbers may be crossed out.):

School Name

Cumulative GPA

Proof of Academic Standing

Please upload the student's most recent Report Card for 2022-2023. Student's name must be clearly displayed in the transcript/report card.

Have you taken the PSAT in the period from July 2021 to today?

Have you taken the SAT in the period from July 2021 to today?

Have you taken the ACT in the period from July 2021 to today?

Have you completed any science research from July 2021 to the Present? What and where?

Have you completed any internships from July 2021 to the Present? What and where?

Parent/Guardian's First Name

Parent/Guardian's Last Name

Parent/Guardian's Email Address

Parent/Guardian's Phone Number

How did you hear about us?

I hereby confirm that the information provided is true and correct.

If the student is selected, please note that the parents/guardians are required to present their tax information for the last two years and proof of address.