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Cox130

Youth Members Form

Welcome to the Cox130 Youth Member Registration:

This form is for middle and high school students (Grades 7–12) who want to participate in Cox130 as presenters, performers, innovators, and storytellers. Please complete all sections so we can place you in the best pathway and prepare for your participation.

Students First name

Last name

Phone

Birthday

Month

Day

Year

Multi-line address

Country/Region

Address

City

Zip / Postal code

School Name

What learning environment best describes your school?

Public School

Home School

Private

Charter

After School Program

Other

Grade

7th

8th

9th

10th

11th

12th

Other

Which math topic interests you most?

Core Math

Algebra & Patterns

Data & Statistics

Problem‑Solving

Technology & Coding

Gaming

Other

How would you like to share your math experience at Cox130?

Demonstration — showing math through models, visuals, or hands‑on examples

Presentation — explaining math using slides or structured speaking

Storytelling — using characters, narrative, or real‑world scenarios

Performance — movement, rhythm, music, theater, artistic interpretation

Collaboration — working with a group to build or solve something

Other

Parent/Guardian Name

Phone

Emergency Contact Name

Emergency Email

Emergency Phone

Parent/Guardian Signature

MathSTEM is registered in the state of Maryland. EIN: 39-3222929

Make Check payable to: MathSTEM Foundation

MMM
MathSTEM Foundation

1910 Towne Centre Boulevard,
Suite 250, Annapolis, Maryland, 21401
United States of America
Phone: 410-421-1895
Email: info@mathstemfoundation.org

Terms & Conditions

Refund Policy

Accessibility Statement

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