Registration Form - It's in the Genes: Unraveling DNA's Secrets
DNA Camp for Middle School Girls
(Girls entering 6th , 7th , and 8th grade in the Fall, 2015)
Date of Birth
Are you Hispanic?
Student ID (Will be assigned)
Citizenship
I am a U.S. citizen
I am a legal permanent resident
Yes
No
Name
Ethnic Origin (Optional)
Address
American Indian / Alaskan Native
Native Hawaiian / Pacific Islander
E-mail
Asian
Phone Numbers (enter number only - i.e. 3132221234)
Black or African American
White
(Primary)
(Secondary)
Camp Information
Price:
When:
Room:
Time:
$160 / student
July 20 - 23 (Monday - Thursday)
S-110
9:00 a.m. - 2:00 p.m.
Emphasis will be placed on fun hands-on activities and REAL lab work highlighting the structure of the cell and the structure and function of
DNA. We will talk about the role of DNA in genetics, health and disease, biotechnology and forensics. Lab activities will include extracting
DNA from plant cells and analyzing DNA using forensic science techniques. We may even solve a mystery in the process!
During lunch (campers will bring their own lunches), women in STEM (science, technology, engineering and math) fields will join the girls for
informal discussions of career paths in these various areas.
Payment Information
(To pay via Visa, MasterCard, or Discover card call (313) 317-6600.)
Credit Card (Visa, Mastercard, Discover)
Cashier's Check
Amount
Check
Check #
Exp
Card #
Security Code
Amount
Money Order
Mail Registrations to: Henry Ford College
MTEC
3601 Schaefer Road
Dearborn, MI 48126
By signing below I certify that the above information is true and I authorize Henry Ford College to release course information to the appropriate funding source if
applicable.
Date
1/29/15
Print Form