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Tarleton 2017 Physics Camp Application First Name, Last Name (Print): Mailing Address: Phone: --------- Age as of June 18, 2017: Email: - High School: - Circle Your Grade in High School For Fall 2017: Fr So Sr Jr Is your parent a current or former member of the military? Y N Are you a Foster Child? Y N Circle The Course You Have Completed: Algebra I Geometry Algebra II Pre-Calculus Biology Chemistry Physics AP Physics If you took Physics/AP Physics, what was your teacher's name: Did you participate in UIL Math/Number Sense/Science Competition? Y If yes, list the events you participated and any awards? Have You Been On Tarleton Campus: y N Rank Your Interest In the Camp's Physics Tracks (1 highest & 5 lowest): Astronomy/Astrophysics Medical Physics Physics of Optics/Lasers Physics of Electronics Nuclear Physics N Name of Teacher/Counselor Writing Letter of Recommendation: _ What are your educational & career goals and how do you think that participating in the camp will help you achieve these goals: Return Completed Application & Demographic Sheet as Email Attachment or by Mail: Dr. Daniel K. Marble, Tarleton Physics Camp Box T-540 Tarleton State University Stephenville, Texas 76402 [email protected] Letters of recommendation may be submitted electronically as an email attachment or mailed to Dr. Marble. Student & Household Demographics The following information is collected for reporting purposes to the Texas Work Force Commission a s p a r t o f o u r g r a n t and will not be used in the selection process. Student Ethnicity: White/Caucasian African American Hispanic Asian Native American Other Number of People in Household: Father's Education (circle): _ High School High School Graduate College College Graduate Advanced Degree Mother's Education (circle): High School College High School Graduate College Graduate Advanced Degree Family Income (Circle): < $25,000 $25,000 - $49,999.99 $50,000-$74,999.99 $75,000- $99,999.99 $100,000 - $124,999.99 $125,000-$150,000 > $150,000