Please complete the application form and return it to (postmarked by March 10):
LABS Program
c/o Georgette Pliml
Hogan 2-100
2205 Tech Drive
Northwestern University
Evanston, IL 60208-3500
Child's Name:______________________
Age:__________
Grade:________
School:_____________________
Circle Preference:
-Morning (10:00 AM - Noon)
-Afternoon (1:30 PM - 3:30 PM)
-Either
Can you attend all four sessions (circle one)? YES
NO
Have you been in L.A.B.S. before (circle one)? YES NO
If yes, what year(s) were you involved?______________
Parent's Name:__________________
Address:_______________________
_____________________________
_____________________________
Parent's Email:_________________________
Home Phone: _____________________
Cell Phone: _____________________
We'd like to find out a little bit about you. Please describe something in the natural world that you find really cool, mysterious, or unusual, and tell us why it interests you. Write, draw, or paint about it and send with your application. Be creative!
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L.A.B.S. is made possible by the Daniel F. and Ada L. Rice Institute for Biomedial Research