WPI Ignite Registration

Prefill section - To Be Hidden

Application ID

Contact ID

Hidden Section

Current Year

high school graduation year

Participant Information

Participant First Name

Participant Middle Name

Participant Last Name

Participant Suffix

Participant Date of Birth

Nickname or preferred name, if different from legal name above. If you provide another first name, we may use it in future communications. Keep in mind that these communications could include messages to parents or caregivers. If you are not comfortable having some people know this first name, you do not need to share it at this time.

Primary Email Address

If a student has an email they check regularly, please input that here. If not, please use a parent email.

Preferred Student Phone (The number to reach the participant while the program is in session)

Sex assigned at birth

Gender Identity

Gender Identity, if not listed

What grade is the participant currently in?

Mailing Address

Street Address

City

State

Postal Code

Country

School Information

School Name

Please type the full name of the school you currently attend.

School City

School State

Demographic Information

Citizenship

Country of Citizenship

Please specify your primary language if not English

Federal agencies, accrediting associations, grant foundations, college guides, and the media ask us to provide statistical information on the ethnic and racial identity of our students and employees. In order to respond to these requests, we ask you to answer the following two questions (which are based on federal guidelines).

The US Standards for the Classification of Federal Data on Race and Identity classify a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race, as "Hispanic or Latino".

American Indian or Alaska Native: "A person having origins in any of the original peoples of North and South America (including Central America), and who maintains tribal affiliation or community attachment."

What is your ethnicity?

Please select one or more of the following to indicate your racial identity or identities.

Parent/Caregiver Information

Relationship to Student

Parent/Caregiver First Name

Parent/Caregiver Last Name

Parent/Caregiver Email

Parent/Caregiver Phone (The number to reach the parent or caregiver while the program is in session)

Parent/Caregiver Mailing Address

Street Address

City

State

Postal Code

Country

Choose Program and Week

You may select one or more weeks, but please do not select the same program more than once. If you do not see a program listed, the program is full. Please make another selection to participate with us this summer.

Choose Program Week 1

Choose Program Week 2

Choose Program Week 3

Choose Program Week 4

You may not select the same program in multiple weeks. Please make a different selection.

Section to be Hidden

Subject 1

Week 1 Program ID

Subject 2

Week 2 Program ID

Subject 3

Week 3 Program ID

Subject 4

Week 4 Program ID

Compare Subjects

Tuition

Tuition

If you have coupon code, please enter it here:

Payment amount

Please note that a tuition payment is required to confirm your attendance. Please review our refund policy.

Payment Information

Cardholder first name

Cardholder last name

Cardholder email address

Cardholder country

Cardholder ZIP/postal code

Credit card number

Enter the full credit card number.

Expiration month

Enter the two digit month, numbers only.

Expiration year

Enter the four digit year, numbers only.

CVV

The CVV is the three or four digit number on the front or back of your card.

Please contact the Pre-Collegiate Outreach Programs Office at pop@wpi.edu or 508-831-4900 with any questions regarding registration. Please review our refund policy.

Pre-Collegiate Outreach Programs

Worcester Polytechnic Institute

100 Institute Road

Worcester, MA 01609-2280

Phone: 508-831-4900

Fax: 508-831-5188

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