2012 Summer ExplorSchool Application
Grade (2011-12)     Date of Birth     Male Female
Last Name    First Name    M.I.
Street Address
City     State    Zip
Home Phone     Work Phone
Name of School:     City 
Name of Parent or Guardian    Home Phone
Parent email     Work Phone
I would like my information on a carpool list. If you check this you will automatically receive the carpool list
INDICATE COURSE CHOICES IN ORDER OF PREFERENCE:
A.M. Course Choices: P.M. Course Choices:
A.M. 1
 P.M. 1
A.M. 2
 P.M. 2
APPLICATION CHECK LIST
  • Completed application form
  • $280 deposit by check (MITY) or by credit card
  • One teacher recommendation (new students only – if you attended YES you are considered a new student)
  • Write a short essay about yourself (new students only – if you attended YES you are considered a new student)
  • Most recent report card

Acceptance emails will be sent once we have received all applications materials and deposit.
EXTENDED DAY:
Extended Day is available to assist working parents during ExplorSchool session. Students may use extended
day either in the morning from 7:30 am – 8:30 am, or after ExplorSchool classes, from 4:00 pm – 5:00 pm.
The cost is $50 per child for morning or afternoon. For both morning and afternoon the cost is $90.
I would like to sign my child up for extended day. Please indicate morning or afternoon.
morning ($50)    afternoon ($50)    Both ($90)
MAIL TO:
ExplorSchool
c/o Minnesota Institute for Talented Youth
1600 Grand Ave. St. Paul, MN 55105
Phone: 651-696-6590    Fax: (651) 696-6592