Student Name *

First Name

Last Name

Student Phone Number *

(###)

###

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What grade are you currently in? *

Grade 10

Grade 11

Parent/Guardian Name *

First Name

Last Name

Parent/Guardian Phone *

(###)

###

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What are you interested in? *

Check as many as apply

Sports / Heath and Fitness

Music / Songwriting

Fashion / Clothing Design

Industrial Design (Wood, Materials, 3D modelling, etc)

Business / Entrepreneurship

Videography / Photography

Digital and Physical Art

Politics / Social Justice / Activism

Science

Computers / Technology / Coding

Writing / Poetry

Other

Agreement *

By submitting this application I understand that I am expressing interest in attending the Propel Program in either the first or second semester

Agree