Student InformationStudent's Name* First Last School*Fall 2026 Grade Level (must have taken Camp Biotech I or High School Biology)* 9th Grade 10th Grade 11th Grade 12th Grade Date of Birth* MM slash DD slash YYYY Dietary Restrictions* Gluten-sensitive Vegan Vegetarian Dairy-free N/A Other (please note below) Allergies, Dietary Restrictions, or other Important Medical Information*Does your student need any special accommodations (mobility, language, sensory, learning, etc.) that we can provide? Please describe.*Why is your child interested in attending this camp, or what are they hoping to learn?* Primary Contact PersonPrimary Contact Name* First Last Primary Contact Address* Street Address City State / Province / Region ZIP / Postal Code Phone Number*Alternate Phone Number*Email* Secondary Contact PersonSecondary Contact Name* First Last Secondary Contact Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone Number*Alternate Phone Number*Email* PaymentHow would you like to pay?* I want to pay $500 today via Stripe (debit/credit card) My student receives free or reduced lunch; scholarship requested $500 Standard Fee*Credit Card ScholarshipEnter your scholarship justification*Please provide us some information on why you are requesting a scholarship for this student. You can use this field, or attach a file below.Scholarship application letterAccepted file types: doc, docx, pdf, txt, Max. file size: 50 MB. If you would prefer, attach a file that describes the reason for requesting a scholarship for this person. Your letter will be forwarded to BTCI for review.