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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.

 

Do you live within driving distance of Seekonk, Massachusetts? Yes   No

 

Where did you hear about the Robotics Art Club?

  If other, where?

 

Why do you want to be in the Robotics Art Club?

 

Have you made any robots? If so, describe your robot.

 

Do you make art? If so, describe your art.

 

Tell us anything else about yourself that we might find of interest.

                                                                                          Copyright © 2005 Robotics Art Club

 

PURPOSE

 

CLUB MEMBERSHIP

WEB CLUB

EXPENSES