Join a Regional Industry Council (RIC)

Astrobiology Program – 8/13 – 8/15

  • Program Dates: August 13th to the 15th
  • Program Cost: $100

Personal Info


First Name: Last Name:
Street Address:
City/Town: State: Zip:
Home Telephone:
Parent’s Email Address: Student’s Email Address:
Age of student at the time that the program will take place:
Parent/Guardian:
US Citizen:
Permanent Resident Alien (PRA)?
Emergency Contact Name:
Emergency Contact Phone:

Academic Information


School/District:
Street Address:
City/Town: State: Zip
Present Grade:


List any medical/special needs:
Parent/Guardian Signature:

By selecting yes, you are agreeing to the terms and
conditions of the Summer Science Explorations programs.

  • Please make a check for the amount of $100 payable to LIMSAT
  • Write your child’s name in the Memo line
  • Mail check to the following address:
    LIMSAT
    Summer Science Explorations
    Brookhaven National Laboratory
    PO Box 843
    Upton, NY 11973

     


Note:

  • BNL does not provide transportation or housing for students.
  • No refunds given if cancellation is made less than 2 weeks prior to program start date.