S. T. A. T. E. Program Application

Tell us about yourself.

Please type in your responses below and click SUBMIT.

Student Information

Last Name: First Name:     DOB (MM/DD/YYYY): Street Address:     Gender: Age: City: State: Zip:     Home Phone: Current School:     Email:

Parent/Guardian Information

First Contact: Second Contact: Daytime Phone 1: Daytime Phone 2: Cell Phone 1:  Cell Phone 2: Email 1: Email 2:

All costs and fees associated with stewardship activities will be paid in full by the Paul Simon Foundation

Emergency Contact (if not one of the above)

Name: Phone: Relationship to Child:

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1.  What will you contribute to the STATE volunteer group?   2.  What do you hope to learn or experience during your time with STATE?   3.  Do you have any skills or previous experience -- be it outdoors, academic, social, or community-oriented -- that might relate to STATE?   4.  How did you hear about the STATE program?  

Want to get a jump on the clearance forms? Download them here.