Smithtown Middle School Smithtown Middle School to open th w o N th D8 7 AN udents st grade PROGRAM for 7th & 8th grade students at Nesaquake Middle School PROGRAM for 7th & 8th grade students at Nesaquake Middle School For information, please contact SCOPE at 631-360-0800 ext 148 jmichelli@scopeonline.us TUESDAYS 10 Weeks March 3, 10, 17, 24, 31 April 14, 21, 28 May 5, 12 2:45-3:45pm *REGISTRATION DEADLINE EXTENDED* February 13, 2015 SCOPE Education Services, in cooperation with the Smithtown School District, is pleased to offer the Middle School Robotics Program to 7th and 8th grade students. This program is designed to focus on Science, Technology, Engineering and Mathematics (STEM) by engaging students using a hands-on approach to learning. Students will be provided with enriching ways to expand their learning while having fun. Take part in this exciting robotics program where students will learn mechanical design, construction, programming & teamwork skills. Together, using building elements, motors & sensors, students will first build then program the robots with a computer to move and react to solve challenges. Come help bring robots to life! REGISTRATION FORM 2014-2015 SCOPE/SMITHTOWN MIDDLE SCHOOL ROBOTICS PROGRAM NESAQUAKE MIDDLE SCHOOL Please enclose a check payable to SCOPE for $200.00 and return with registration form to: SCOPE/Smithtown Middle School Robotics Program 100 Lawrence Avenue Smithtown, NY 11787 *NEW* Registration Deadline is Friday, February 13, 2015 Last Name: __________________________ First Name: _______________________ Home Address: ________________________________________________________ ________________________________________________________ Current Grade: __________ School: __________________________ Parent/Legal Guardian: __________________________________________________ LOCATION: Nesaquake Middle School PROGRAM COST: $200.00 per student Home Phone: ______________________ Cell Phone: _______________________ Work Phone: ______________________ *NEW* REGISTRATION DEADLINE: Friday, February 13, 2015 Email Address: _________________________________________________________   Emergency Contact: ___________________________ Phone #: _________________ There will be a $25.00 fee for any returned checks or declined credit cards. Course fees will not be refundable after Friday, February 13, 2015. Refunds issued prior to February 13th will incur a $10.00 processing fee. Online registration is available and highly recommended to ensure your child’s placement. Please visit www.scopeonline.us. Go to Child/ Student Services. Under School Year Enrichment Programs, click on Smithtown Middle School Robotics. Please Note:  Registrations will be accepted on a first-come, first-served basis. Classes fill up quickly. There is a strict limit of 20 students per class.  SCOPE requires a minimum enrollment to run each class.  SCOPE reserves the right to cancel a course due to insufficient enrollment. For information, please contact SCOPE at 631-360-0800 ext 148 jmichelli@scopeonline.us Health Concerns: _______________________________________________________ _____________________________________________________________________ _____________________________________________________________________ I Do/ I Do Not (CIRCLE ONE) give permission for my child to appear in any SCOPE media coverage. Please complete the information below to pay by credit card. (If paying with credit card, forms may be faxed to (631) 979-2037) Cardholder’s Name: ___________________________________ Cardholder’s Signature:_________________________________ Credit Card Number: ___________________________________ Expiration Date: _____________Security Code:_____________ Online registration is available and highly recommended to ensure your child’s placement. Please visit www.scopeonline.us. Go to Child/Student Services. Under School Year Enrichment Programs, click on Smithtown Middle School Robotics.