GEMS Application

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Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Camper's Email*
Campers will need this email to complete pre and post survey if selected to attend camp.
Home Phone Number*
Date of Birth*
Current Grade (18-19 school year)*
- 6th Grade
- 7th Grade
- 8th Grade
Racial/Ethnic Group (optional)
- Asian or Pacific Islander
- Black, Non-Hispanic
- Hispanic
- Native American
- White, non Hispanic
Parent or Guardian Name*
First Last
Parent or Guardian Email*
Work Phone*
Have you ever applied to attend GEMS in the past?*
- Yes
- No

Name of Current School*
School District/City*
What type of school do you attend?*
- Public
- Parochial
- Private
- Home School
- Charter
What grade level mathematics are you studying this year?*
- 6th
- 7th
- 8th
- 9th
What grade level science are you studying this year?*
- 6th
- 7th
- 8th
- 9th
How do you use computers (surf the web, play games, write programs, word processing, etc.)?)*
Have you done any programming or webpage development? Have you taken a computer class?*
Have you participated in math or science programs outside of school ?*
- Yes
- No
If yes, to the previous question, please name the program. If No, please skip this question.
Why would you like to participate in PennGEMS? (Please have the student answer this question without assistance!)*
All Robotics track – Spend all week in the robotics lab learning about and playing with robots. Space in the robotics only track is limited. No prior robotics experience preferred. Are you interested in the Robotics only track?*
- Yes
- No
Please tell us about yourself by answering the following questions if applicable.
Have you participated in a competition in school? Describe the competition.
Have you participated in a competition outside of school? Describe the competition.
List Academic Awards or Honors in school.
List Academic Awards or Honors outside school.
Have you participated in other academic summer camps? Name of program/s
Please add any other pertinent information about yourself.

Please tell us about yourself by answering the following questions if applicable.