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The
Robotics Art Club is a free club. It is considered an honor and a
privilege to be accepted as a member. We are looking for bright,
enthusiastic children that show potential in math, electronics,
engineering, design or computers.
If
you would like to be considered for club membership by the existing club
members, please fill out this form and submit it. It will be
automatically sent to all the club members. The club leader will respond
within two weeks.
This
form must only be filled out by yourself, not your parents or anyone
else. Please take your time -- this is one of the ways we judge
potential members.
|
| Name |
First
Name
MI
Last
Name
|
| Address |
Street
Address
Second Address
(optional)
City, State, Zip |
| Email |
Email
Address
The Robotic Arts Club is
organized via the Internet. An email address is required to join this
club.
Mother's
Email Address
Father's
Email Address |
| Parents |
Mother's Full Name
Father's Full Name |
| Phone |
Area Code + Local Phone Number
Parent's Phone Number, if different from
above.
|
| Age |
How old are you? 10
11
12 13
14
The Robotics Art Club
is restricted to ages 10 through 14. |
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Do you live within driving
distance of Seekonk, Massachusetts? Yes
No |
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Where did you hear about the
Robotics Art Club?
If other, where? |
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Why do you want to be in the
Robotics Art Club?
|
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Have you made any robots? If
so, describe your robot.
|
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Do you make art? If so,
describe your art.
|
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Tell us anything else about
yourself that we might find of interest.
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Copyright © 2005 Robotics Art Club |