Student Interest Form Fields with an asterisk (*) are required. Student's Name* First Middle Initial Last Home Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Age*Please enter a number from 13 to 18.Birthdate* Class*Freshman, Sophomore, Junior, SeniorSchool*Student Home Phone*Student Email* Student Mobile PhoneParent/Guardian Name* First Middle Initial Last Parent Email* Parent Mobile PhoneParent Work Phone*Please provide brief answers to the following sections in the space provided:1. What are your top 5 favorite projects on this site?*View the projects here.2. List your participation in other extra-curricular activities. (i.e., Student Council, Science Olympiad, FRC, band camp, drama, FBLA, MESA, publications, athletics, etc.)*3. List any special skills (i.e., software packages, media design, public speaking, mechanical design, manufacturing, writing, etc.)4. List three careers that interest you:*5. Indicate your anticipated education/degree goal beyond high school:*AssociateBachelorsMastersDoctoratePlease send me Power Mountain Engineering's free email newsletter. Sign me up! (I can cancel at any time and my information won't be shared.) I want to be contacted by Power Mountain Engineering.* I agree. By submitting this form, you consent to be contacted by us. We won't use this personal information for any other purpose, and it will not be shared.NameThis field is for validation purposes and should be left unchanged.