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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.
 

2027 Timeline

  • Applications Open: October 19 – November 29

  • Selections: November 30 - December 4

  • Notifications: December 7 - 18

  • Program Instruction: February 10 - April 17

  • One Saturday In-person Lab Session
    AM Session 9:00am-Noon
    Mid-day Session 11:30am-2:30pm
    PM Session 2:00pm-5:00pm
    and 
    One Weekday Virtual Session
    Wednesday or Thursday
    ​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.

Student Information

Have you previously participated in a LIFT-VA instructional cohort?
New Student (Level 10) — I have not participated in a previous cohort.
Returning Student (Level 20) — I participated in at least one previous cohort (available to 9th -12th grade students only).
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

Grade Group
Middle School Campus Location (In-Person)
High School Campus Location (In-Person 1st Choice)
High School Campus Location (In-Person 2nd Choice)
Middle School Class Time Selection (In-Person)
High School Class Time Selection (In-Person)
Level 20 Class Time Selection (In-Person)
Instructional Cohort #3 will begin on February 10 and conclude on April 17. 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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