2016 ATOMS
Scholars Program Student Application
Parents and Students: Please read this paragraph and complete all the requested information in Parts I and II.
PLEASE NOTE: INCOMPLETE APPLICATIONS WILL AUTOMATICALLY BE DISQUALIFIED. After completing Parts I &
II, forward this application to your child's teacher. Send the application early enough to allow for completion of Part III and receipt at
IU8 by the deadline. The school will forward the completed application to the IU8. Acceptance into this program is competitive and
receipt of an application does NOT indicate admission. For more information visit our website: www.iu08.org/atoms
Part I (Must be typed or printed neatly)
Student's Name:
Address:
City, State:
School District or Diocese you attend:
(Must presently be enrolled in grade 2 - 8)
Grade Level: 2015 - 16 yr.
Boy
Girl
Zip Code:
Building:
Parent or Guardian Name:
Parent or Guardian E-mails:(1)
(2)
Parent contact phone number: Home:(
)
Cell:(
)
Other:( )
Has this child attended the ATOMS Scholars Program during the past three years?
Yes
No
List any extracurricular interests or honors received by this child in regards to Math/Science (Science Fair, Scouts, etc.)
*Applicants (NOT PARENTS): In the space provided, print or type a paragraph on why YOU want to attend this program.
This needs to be more than one sentence saying you like science and math.
Program Choices:
When indicating which one of the 13 sites you want to attend, place a 1 beside your first choice and a 2
beside your second choice.
ATOMS Mini: These are 3 full-day or 4 half-day hands-on, high level, science and math laboratory experiences for students in
grades 2-8 who demonstrate high enthusiasm, excitement, and motivation in those areas. Students will also need a teacher
recommendation. Total tuition cost is $80 ($30 nonrefundable acceptance fee + $50 program fee) and includes classroom materials
and supplies. Transportation and lunch are NOT included.
3 Day Mini
8:45 – 2:20
______ Northern Cambria Elementary/Middle (Northern Cambria, PA)
July 5 - 7
(Tues. – Thurs.)
______ North Star High School (Boswell, PA)
July 6 – 8
(Wed. – Fri.)
______ Somerset Junior High School (Somerset, PA)
July 19 – 21
(Tues. – Thurs.)
4 Day Mini
8:45 – 12:40
______ Shade Middle/High School (Cairnbrook, PA)
June 14 – 17
(Tues. – Fri.)
______ Penn Cambria Middle School (Gallitzin, PA)
June 21 – 24
(Tues. – Fri.)
______ Bellwood-Antis Middle/High School (Bellwood, PA)
June 28 – July 1
(Tues. – Fri.)
______ Tussey Mountain High School (Saxton, PA)
July 11 – 14
(Mon. - Thurs.)
ATOMS Basic: These are 5 full-day hands-on, high level, intensive science and math laboratory experiences for students in grades
2-8 who demonstrate high enthusiasm, excitement, and motivation in those areas. Total tuition cost is $120 ($40 nonrefundable
acceptance fee + $80 program fee) and includes classroom supplies and materials. All sites have a 30-minute lunch period.
Transportation and lunch are NOT included.
5 Day Basic
8:25 – 2:50 All Basic programs run Monday - Friday
______ Everett Area Middle/High School (Everett, PA)
June 13 - 17
______ Rockwood Area Jr/Sr High School (Rockwood, PA)
June 20 - 24
______ Hollidaysburg Area High School (Hollidaysburg, PA)
June 27 – July 1
______ Forest Hills Middle School (Sidman, PA)
July 11 – 15
______ Blacklick Valley JR/SR High School (Nanty Glo, PA)
July 18 – 22
______ Berlin Brothersvalley Middle School (Berlin, PA)
July 25 - 29
Students will be notified by mail if they have been invited to participate in this year's ATOMS Scholars Program. Upon receipt
of the acceptance letter payment is due online via the IU8 system by May 1 2016.
DO NOT SEND ANY MONEY WITH THIS APPLICATION.
I give my permission for
to apply for the 2016 ATOMS Scholars Program. I
understand that selection for this program is competitive and my child’s receipt of an application does not guarantee admissi on.
SIGNED:
Part II: FINANCIAL AID (Parents/Guardians: Please read and indicate your financial need.)
Scholarships are available for students with a financial need. If requesting financial assistance, you must provide proof of your
household income & number of dependents when submitting this application. Financial aid is determined based on the income
guidelines set for the free and reduced rate lunch programs. Forms accepted as proof of income are: a copy of your lunch program
letter indicating your eligibility for free or reduced rate lunches (preferred item) or if the letter isn’t available, a copy of your 2014 or
2015 income tax form indicating the number of dependents and your household income. Check the appropriate line:
No Aid Needed
Yes*, Full Program Fee Scholarship
(Student pays acceptance fee only)
*If yes, include proof of income. Applications requesting aid without proof will be disqualified for financial aid.
PARENTS: STOP AT THIS POINT AND SEND THIS APPLICATION TO YOUR CHILD’S SCHOOL FOR COMPLETION
AND SUBMISSION TO APPALACHIA IU8.
Part III: (THIS SECTION IS TO BE COMPLETED BY SCHOOL PERSONNEL.)
School Personnel: (Please read this before completing Part III.)
Please complete items A through D. If the student has a different teacher for math and science make sure both teachers
complete their sections. It is beneficial if you or some other school personnel include comments concerning this child's eligibility for
this program. Many times it is the teacher comments that determine a student's placement in the program. All comments are
always confidential.
A.
Teacher Input: In this section please help to determine student motiviation, growth and achievement based on the following
criteria. Please circle. 5 being the highest.

Motivation when presented with new ideas
1
2
3
4
5

Enthusiasm toward learning
1
2
3
4
5

Ability to work cooperatively in groups
1
2
3
4
5

Growth in achievement while in your class
1
2
3
4
5

Performance on state and local assessments
1
2
3
4
5
B.
Teacher Recommendation:
Very highly recommend
Highly recommend
Recommend
Recommend with reservation
Do not recommend - Comment:
C.
Brief Description (more than 1 sentence) Verifying Recommendation:
____________________________________________________________________________________________
_
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
D.
School Personnel Name:
School:
______________
Date Form Completed:
School Personnel please return the completed via email:
[email protected]
Note: To see an overview of the ATOMS Program
visit our website at www.iu08.org/atoms
Application Deadline is Friday, February 26, 2016