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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: May 4 – June 4 

  • Selections: June 5 – June 7 

  • Notifications: June 8 

  • Program Instruction: June 22 - August 14
    Monday and Wednesday
    Morning Cohort 9:00am-1:00pm
    Afternoon Cohort noon-4:00pm   


Program format: four hours per day, two days per week, over eight weeks.

 

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

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Application Type:
New Applicant
Returning Applicant

Parent / Guardian 1

Multi-line address
Preferred Method of Contact:

Parent / Guardian 2

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

Multi-line address
Preferred Method of Contact:

Student Information

Birthday
Month
Day
Year
Gender
Multi-line address

Emergency Contact information

Academic Information

Core Academic Interests (Select all that apply):
Have you (student) participated in any of the following?
Do you (student) have prior experience with any of the following?

Interest Questions

Availability

Which lab location would you like to attend?
Loudoun Campus
Manassas Campus
Open to attending at either campus.
Is your student available for the full 8-week cohort schedule?
Are you able to commit to program requirements (attendance, participation, assignments)?
Yes
No

Health & Special Requirements

Does the student have any medical conditions?
Yes
No

Additional Information

Consent & Agreement

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