Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
SHELL ENERGY CAMP LOUISIANA 2018
Fill out the following information if would like to attend the free SHELL ENERGY CAMP June 4 to June 8. You will be emailed within 2 weeks of receipt with further information.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Student First Name.
*
Type your first name. No nicknames, please.
Your answer
Student Last Name.
*
Your answer
Which school do you currently attend?
*
Choose
Benjamin Franklin High School
Alfred Bonnabel Magnet Academy High School
Cabrini High School
Dr. Martin Luther King Jr. Charter School for Science and Technology
Eleanor McMain Secondary High School
Haynes Academy
International High School of New Orleans
Kenner Discovery Health Sciences Academy
Kipp Renaissance High School
Lake Area New Tech Early College High School
Lusher Charter School
McDonough #35 Senior High School
New Orleans Charter Science and Math Academy (Sci Academy)
New Orleans Charter Science and Mathematics High School (Sci High)
Patrick F. Taylor Science & Technology Academy
Sophie B Wright Charter School
Warren Easton Senior High School
Other
Abramson Science Academy (Collegiate Academies)
Chalmette High School
Crescent Leadership Academy
East Jefferson High School
Edna Karr High School
G.W. Carver High School (Collegiate Academies)
Grace King High School
Helen Cox High School
Holy Cross School
John Ehret High School
Joseph S. Clark Preparatory High School (First Line Schools)
Kipp Booker T Washington
L.B. Landry High School
Livingston Collegiate Academy (Collegiate Academies)
Morris Jeff Community School
New Orleans Military and Maritime Academy
NO College Prep
Riverdale High School
St. Augustine High School
Thomas Jefferson High School for Science and Technology
Write the last name of your current science teacher.
*
Your answer
In what grade are you currently enrolled?
*
9
10
11
Other
Select the year in which you were born.
*
Choose
1999
2000
2001
2002
2003
2004
Other
Enter your (student) cell phone number including area code. If you do not have a cell phone, leave the space blank.
Do NOT include dashes or spaces. Example: 5048125452.
Your answer
Enter an adult (parent or guardian) telephone number including area code.
*
Do NOT include dashes or spaces. Example: 5048125452
Your answer
Enter your personal (student) email address.
*
If you do not have an email address, leave this bank. Example:
ilovescience@gmail.com
Your answer
Enter an adult (parent or guardian) email address.
If you do not have an email address, leave this bank. Example:
adult@gmail.com
Your answer
I will be able to attend camp orientation the evening of Thursday, May 31. Orientation attendance is preferred but not mandatory.
*
Answer on a of scale 1-5, 1 being the lowest and 5 being the highest.
Strongly disgree
1
2
3
4
5
Strongly agree
I will be able to attend the entire week of camp.
*
Answer on a scale of 1-5, 1 being the lowest and 5 being the entire camp.
One day only
1
2
3
4
5
All 5 days
Select the answer that BEST describes you.
*
Please be honest with your answers. If you do not like math, it's OK to say so. We hope by the end of camp you will like it at least a little more!
Agree
Sort of Agree
Not Sure
Sort of Disagree
Disagree
I like science.
I like math.
I think science class in school is boring.
I think math class in school is boring.
I feel like I can talk to my teacher about a career (job) in science or math.
Agree
Sort of Agree
Not Sure
Sort of Disagree
Disagree
I like science.
I like math.
I think science class in school is boring.
I think math class in school is boring.
I feel like I can talk to my teacher about a career (job) in science or math.
State why you are interested in attending the camp and what you hope to learn.
*
Please limit your response to 250 words.
Your answer
How did you hear about us?
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
