Online Application Welcome to Mini-Courses Saturday Academy Program. The information below will provide Mini-Courses with official registration for the program. The registration will need both the student and parent/guardian’s signatures. Step 1 of 4 25% HiddenPayment Method*- Select -DPI Scholarship Pre-College Scholarship ApplicationPayment of $120.00 will be mailed to Mini-Courses at time of registrationI am requesting a payment plan and ask that Mini-Courses contacts me directlyMini-Courses can only accept payments of cash or check/money order (made payable to UW-Milwaukee, Mini-Course Program) by mail only. Credit card /over the phone payments are not available. Mail Payments to: UWM Mini-Courses P.O. Box 413 Milwaukee, WI 53201-0413 Payment Method* DPI Scholarship Pre-College Scholarship Application Payment of $125.00 will be mailed to Mini-Courses at time of registration I am requesting a payment plan and ask that Mini-Courses contacts me directly Mini-Courses can only accept payments of cash or check/money order (made payable to UW-Milwaukee, Mini-Course Program) by mail only. Credit card /over the phone payments are not available. Mail Payments to: UWM Mini-Courses P.O. Box 413 Milwaukee, WI 53201-0413 DPI Pre-College Scholarship Application*Accepted file types: docx, pdf, doc, jpg, png, Max. file size: 5 MB.Applications can be found on the DPI Pre-College Scholarship Program page. Download, complete, and sign the scholarship form to upload it here. If you are unable to scan a signed copy we can also accept a picture of the signed scholarship form emailed to minicourses@uwm.edu. If you need assistance, please contact the Mini-Courses office for alternatives. Student's Name* First Last Birthdate* MM slash DD slash YYYY Sex*- Select -FemaleMaleSchool Attending* Current Grade*- Select -678A relative of mine is also attending Mini-Course Saturday Academy*- Select -YesNoName of relative* Preferred Language- Select -EnglishSpanishPrimary Contact InformationName* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Relationship to Student* Home PhoneWork PhoneNotifications & AlertsMobile PhoneEmail Household InformationHave you earned a bachelors degree from a four-year college or university? (Female)*- Select -YesNoHave you earned a bachelors degree from a four-year college or university? (Male)*- Select -YesNoDoes your family qualify for Free or Reduced lunches?*- Select -YesNoDoes your family qualify for or receive any other forms of state or federal support (TANF, food stamps, etc.)?*- Select -YesNoEthnicityWhat is the student's ethnicity? Please check ALL that apply.Ethnicity* Puerto Rican Mexican American, Chicano, a Cuban Not Spanish, Hispanic, Latino, a Other Spanish/Hispanic/Latino group Other* RaceWhat is the student's race? Please check ALL that applyStudent's Race* American Indian/Alaskan Native Asian Indian Black or African American Cambodian Chinese Filipino Guamanian or Chamorro Hmong Japanese Korean Laotian Native Hawaiian Samoan Vietnamese White Other Asian Other Race Tribe & Reservation* Please specify principal WI or other tribe & reservation.Other Asian Race* Other Race* HiddenAreas of InterestPlease select only three that apply.HiddenAreas of Interest Agriculture Architecture Arts/Humanities Athletics Business Computer Education Engineering English/Literature Environment Health Care History Languages Law Math Medicine Music Natural Science Nursing Politics Social Science/Culture Study Skills Other HiddenOther Class ConsentConsent* I give consent to the UWM Mini-Course Program to access post-secondary enrollment verification information for the purpose of assisting them in supporting and tracking their students, as well as to help support program initiatives. I understand that I have the right to rescind this consent at any time by contacting the UWM Mini-Course Program.*Consent* This consent form will remain in effect until the above named student graduates from middle school or until the program is notified to the contrary by the parent/guardian.*Parent/Guardian Name* Parent/Guardian Signature*By signing this you are giving consent to allow the student to participate in the UWM Mini-Course Program.Consent My child has special needs and/or requires accommodationsPlease contact the Mini-Courses Director.Emergency Contact InformationName and address of relative or close friend to be contacted in case of emergency if we are unable to reach parents/guardian.Name* First Last Relationship to Student* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Primary/Home Phone*Work PhoneMobile Phone Behavioral ContractOur programs and activities are designed to help you increase your academic and social abilities -- helping you work toward a better future. For this reason, all students have the responsibility to help maintain the best possible atmosphere for learning so that everyone will be able to do his/her best. By paying attention, following directions, participating in activities and, most of all, by treating everyone with respect, you will be helping to accomplish this goal. Both parents and students are asked to read and sign this paper below. Thank you! Student Responsibilities To behave in a respectful manner to presenters, tutors, program staff, and other students. To avoid abusive or loud language. To ask questions if you do not understand what is being discussed. To respect the property of other students, presenters, tutors, and the university. To arrive on time and remain for the entire session. To not bring radios, headphones, beepers, or cellular phones to workshops or tutoring sessions. To not wear hats or caps during programs, except where a student may have a religious or closely held belief for doing so. A student bringing any kind of weapon will automatically be dismissed from the program. To not engage in any inappropriate conduct, including sexual activity, while participating in any aspect of the program. To not engage in any illegal activity while participating in any aspect of the program, including possession or use of alcohol or controlled substances without medical authorization. Students not maintaining these standards will typically be warned and the parents will be contacted. Following a second warning, and upon consultation with the staff, a student may be dismissed from the program. UWM, however, reserves the right to impose discipline as it deems appropriate, including automatic dismissal from the program. Parent/Guardian Responsibilities: To encourage your student to participate and do his/her best -- your interest and involvement are crucial to their success. To participate in parent workshops as often as possible. They will provide you with information which will help you and your student. Your involvement sends a strong message to your student that these programs are an important contributor to their success. To provide transportation to and from the program -- please be sure that the student arrives on time and is picked up promptly. To communicate with the program in writing about any special needs or circumstances. For example, if a student attending alone needs to leave early, please send a note. Thanks to all parents and students for your understanding and cooperation in these matters! I have read and agree to abide by the above expectations for the Mini-Course Program.Signature of Participant*Parent/Guardian Signature* Assumption of RisksYou are being asked to sign this form because you would like to participate in the above-listed event (Mini-Course) sponsored by the University of Wisconsin-Milwaukee (“UWM”). Before you can participate, UWM asks that you read this document carefully. If you want to ask questions about this document or request changes to it, you can do so by contacting the party listed above. By participating in Mini-Course, you are putting yourself at some risk (e.g., harm by other participants, etc.). The specific risks vary from one activity to another, but resulting injuries can range from minor (e.g., scratches and bruises), to major (e.g., fractures and internal injuries), or catastrophic (e.g., paralysis and death). UWM recommends you minimize your risks by carrying insurance (insurance is not provided by UWM). Please sign here to indicate that you understand that risks are inherent in the Mini-Course program and you knowingly and willingly accept those risks.Signature of Participant*Parent/Guardian Signature* Waiver of RightsIn exchange for allowing you to participate in the Mini-Course Program, UWM asks that you agree not to make a claim against UWM if you are injured while participating in the Mini-Course Program, even if your injury was caused by UWM’s negligence. This means you are giving up your right to sue UWM if you injured during the Mini-Course. “Injury” refers to injuries to both your body and your property, whether caused by a UWM employee or a third party. You are not being asked to give up your rights in the event UWM acts recklessly or in an intentionally destructive manner. Please sign here to confirm that you are willing to give up your claims and rights against UWM in the event you are injured (including the right to sue).Signature of Participant*Parent/Guardian Signature*PhoneThis field is for validation purposes and should be left unchanged.