Stem at Home

Survey Fall 2022

Thank you for taking the time to fill out this survey. I will get back to you as soon as possible with a way forward for our after-school STEM program.

Student Name

First Name

Last Name

Grade

Room 1 3rd year

Room 2 3rd Year

4th year

Parent Name

First Name

Last Name

Email

I am interested in After-School STEM Fall 2022

Yes

No

Comment

(optional)

Subject