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Secondary School / Grade 6 - 12  Application

Thank you for your interest in LIFT-VA.


This form is for parents, guardians, and secondary school students interested in participating in the LIFT-VA secondary school pathway.
 

LIFT-VA helps students explore science, build confidence, and engage with future-focused opportunities in life sciences, STEMM, and workforce readiness.
 

2026 Timeline

  • Applications Open: July 29 – August 14 

  • Selections: August 15 – August 20 

  • Notifications: August 21 - August 31 

  • Program Instruction: September 21 - November 21

  • Saturday Lab
    Morning Session 9:00am-Noon or 
    Afternoon Session 11:30am-2:30pm
    and
    One virtual weekday session
    6:00pm-8:00pm 


Program format: one 3 hour Saturday Lab and one 2 hour virtual class, over eight weeks.

 

Please complete the form below so our team can learn more about your student’s interest.

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Student Information

Have you previously participated in a LIFT-VA instructional cohort?
New Student — I have not participated in a previous cohort
Returning Student — I participated in at least one previous cohort.
Birthday
Month
Day
Year
Gender
Are you Latinx or Hispanic?
Please select all ethnicities with which you identify
State
County

School Information

School District Name
What Grade will you be in at the start of the LIFT-VA Instructional Cohort?
What best describes your current cumulative GPA or academic standing?

Please select the range that best matches your current grades. You do not need to provide your exact GPA.

Parent / Guardian Information

Adult 1 Relationship to Student
Preferred Method of Contact:

If a second parent or guardian is not applicable, you may leave this section blank.

Adult 2 Relationship to Student
Preferred Method of Contact:

Campus / Class Selection

Campus Location (In-Person)
Class Time Selection (In-Person)
Virtual Instruction Class Date (1st Choice)
Virtual Instruction Class Date (2nd Choice)
Instructional Cohort #2 will begin on September 21 and conclude on November 21. Are you able to commit to participating for the full duration of this instructional cohort?
Yes
No

Interest Questions

Core Academic Interests (Select all that apply):
Have you worked in a research laboratory?
Yes
No
How long have you conducted research?

Answer in a few words. Place N/A if you didn't participate in a research project.

Have you authored or co-authored a peer-reviewed publication?
Yes
No

Consent & Agreement

How did you hear about LIFT-VA?
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