Computer Science and Engineering 2021 Application for 9th and 10th Grade GEAR-UP Jefferson County Students To be eligible for participation, applicants should: ▪ Currently be entering 9th and 10th grade attending a *GEAR UP Jefferson County School. ▪ Have an interest in and a demonstrated aptitude for computer science. ▪ Commit to being present on all days of the session. ▪ Submit a COMPLETED APPLICATION PACKET which includes: 1. The following Application Form 2. A current high school transcript 3. A letter of recommendation from a technology teacher Deadline for Applications: May 21, 2021 by 5:00 pm Completed applications must be emailed to [email protected] UAB-CORD Computer Science and Engineering 2021 APPLICATION Requested session to attend (please check one): June 21-25________ July 26-30________ Contact Information: Applicant Name Date of Birth Mailing Address ____ City State Zip Code Telephone Number (Home) (Cell) Email Race M/F Name of Parent(s)/Guardian Mailing Address (if different) City State Zip Code Phone (Daytime) (Cell) Academic Information: 1. School that you will attend next fall and the grade you will enter: School District: 2. Scholastic awards or honors received: *Students entering 9th and or 10th grade in the following schools receive a Gear Up scholarship for the entire tuition. Please check if you plan to attend one of the following schools, in the fall, below: Bessemer City High Fairfield High Prep Midfield High School Tarrant High School Clay-Chalkville High Center Point High School Fultondale High School Hueytown High School Shades Valley High McAdory High School Minor High School Pleasant Grove High Pinson Valley High I certify that the information contained in this application is correct and complete for participation in the Computer Science program held at UAB-CORD June 21-25 OR July 26-30 from 9am to 3pm daily. This application must be mailed or emailed to Steven A. Wyss at [email protected] by May 21, 2021. Applicant Signature Date UAB-CORD Summer Science Institute CHSB19, 5th Floor, 933-19th Street South Birmingham, AL 35294-2041 Office Phone: 205-934-5171 [email protected] UAB Center for Community OutReach Development (CORD) Summer Programs Disclaimer: Summer Programs are planned to be held, in-person, in the CORD lab space on UAB Campus. If adjustments are needed to be made, due to COVID- 19, the programs will be held virtually. .