IMSA Kids Institute

We love to hear from you!Tell us anything you like: what you like about the Kids Institute, what you dislike, what you want to see in its future, how you've used the Kids Institute, etc

Date
* Student's LAST Name
* Student's FIRST Name
Student's Current Grade
* Street Address
* City
* State
* Zip
* Parent or Guardian Name
* E-mail Address
Phone Number

Ethnic Information is requested so that IMSA may demonstrate compliance with federal requirements

My child is:
American Indian or Alaskan Native
Asian or Pacific Islander
African American
Latin
Caucasian
Biracial or Multiracial

How did you hear about IMSA or the Kids Institute?
Newspaper
IMSA Website
Internet Search Engine
Friend
School
Other (please explain)

What Kids Institute Programs have your participated in? (check all that apply)
Summer Camp
Workshops
Summits
Offsite Programs

I've Participated in Other IMSA Offerings

Any additional comments?

Kids Institute® Contact Information:
Phone: 630-907-5987
Fax: 630-907-5880
kidsinstitute@imsa.edu

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Created by K Pfeifer

Latest Update 8/15/2008