
Personal Information about the
Participant:____________________________________________________
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Address: ______________________________ E-Mail: ______________________________________ City, State, ZIP_________________________ |
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Parent/Guardian Name: _____________________ Telephone:
______________________________________ Address:
_________________________________ E-Mail:
_________________________________________ City, State, ZIP:
____________________________________________________________________________ |
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Ethnic background (voluntary), used to
enhance our programming efforts. American Indian or Alaskan Native Asian or Pacific Islander Black (African American, not of
Hispanic origin) Hispanic White (not of Hispanic origin) |
Formal Computing & Mathematics Education:_________________________________________________
(Most recent first. Start with plans for next year if you intend to take a
computer or math class.)
Course Title or Content Description Year Taken Grade Level
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Informal Computing Education:
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Does your family
own a home computer? (Yes or No) How many hours do you spend using the computer each week? _________ No experience |
Briefly describe your typical home computer use. (None is an acceptable answer.)
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All participants:
Describe any Mathematics or Computer camps you have attended, Mathematics or Computer clubs to which you have belonged, etc.
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Briefly describe what you expect to gain from attending the WOMAC Camp.
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Transportation:
Would you need
assistance to be able to attend this camp?
_____________________________
Fee:______________________________________________________________________________________
Please remember to
include a $25.00 check payable to WOMAC. Please do not send cash.
Applicant Signature: ______________________________________________________ Date: _____________
Parent / Guardian Signature:
________________________________________________ Date: _____________
_________________________________________________________________________________________
Applications received after
Please send completed application to:
Dr. Susan Talarico, Advisor
ATTN: WOMAC CAMP
Department of Mathematics and
Stevens Point, WI 54481
E-mail: stalaric@uwsp.edu
Itinerary

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9:00 |
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Registration
Starts |
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9:30 |
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Go Over
Guidelines |
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9:45 - 12:00 |
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First Core
Segment |
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12:00 - 1:00 |
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Lunch / Social Hour Outside Activity |
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1:00 - 3:30 |
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Second Core
Segment |
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3:30 - 4:00 |
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Outside Activity |
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4:00 - 4:30 |
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Reception |


I, ________________________(print
parent’s name), hereby grant permission to the University of
Wisconsin – Stevens Point to use my child’s photograph on the World Wide Web or
in other official university publications without further consideration, and I
accept the university's right to treat the photograph at its judgment. I also
accept that the university may choose not to use my photo at this time, but may
do so at its own at a later date.
Parent’s Signature:
____________________________
Date:
____________________________
WOMAC Camp – Internet Release Form
At the WOMAC camp, your child will be using the Internet to either do research or to complete her assigned projects.
We need your
permission to allow your child to use the Internet. The Internet is
unrestricted at the
Your child will be supervised by a camp staff member during her internet use.
****************************************************************
I, ________________________ (print parent’s name), hereby
grant permission to the
I,
________________________ (print
student’s name), understand that the Internet is unrestricted. I will
not attempt to locate material on the Internet that is not directly related to
course work.
Student’s Signature: ____________________________
Parent’s Signature: _____________________________
Date:
_______________________________________


