High School Mathematics Research Enrichment Program Application

STUDENT INFORMATION

First Name

Last Name

Birthdate

Email Address

Mobile Phone

Do you agree to receive text messages from New York Tech?

Yes

No

Home Address

Country

Street

City

Region

Postal Code

PARENT INFORMATION

Parent/Guardian First Name

Parent/Guardian Last Name

Parent/Guardian Email

Parent/Guardian Phone

EMERGENCY CONTACT

Emergency Contact Full Name

Emergency Contact Relationship to Child

Emergency Contact Phone Number

ACADEMIC INFORMATION

Most Recent School Attended (Choose Unknown or Unlisted School, if not found)

In Fall 2026, what grade with you be entering?

Have you completed at least one year of precalculus or an equivalent/higher-level mathematics course.

What is your current GPA?

Please list the math courses you have taken in high school so far by number and description. (Include the courses you are currently taking.)

Are you comfortable using computers for basic tasks (e.g. spreadsheets or web browsing)?
Note: No prior coding or calculus experience is required.

STATEMENT OF INTEREST

Why do you want to participate in the High School Mathematics Research Enrichment Program? What are your academic interests and goals?

SKILLS AND EXPERIENCE

Describe any experience you have with problem-solving, math competitions, coding, or research (if any). If none, type N/A.

ADDITIONAL INFORMATION

What is your preferred campus for the summer camp?

If the program is full, are you interested in being put on a waiting list?

Yes

No

Any dietary restrictions or special accommodations?

COMMITMENT

I am available to attend all camp dates (July 7-9 & July 14-16, 2026)

I am willing and able to participate in the year-long academic mentorship.

SUPPORTING MATERIALS & RECOMMENDATION

Unofficial transcript

Resume (optional, but recommended)

Please provide the name and email address of one mathematics teacher who can provide a brief recommendation for your participation in this program. To ensure full consideration, please have your recommender send their letter directly to Dr. Baole Wen at bwen@nyit.edu by June 10, 2026.

Note: You must also complete and return these forms by the required due date.

AGREEMENT & CERTIFICATION

I certify that the information provided is accurate and complete. I understand that participation requires full commitment to both phases of the program.

Student Signature

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Parent/Guardian Signature (if under 18)

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