Robotics Interest Form

First name*

Last name*

Email*

Phone*

Grade level*

6th

7th

8th

9th

10th

11th

12th

Other

School Name*

Parent/Guardian First Name*

Parent/Guardian Last Name*

Parent's Email

Parent's Phone Number*

Do you have any prior experience with robotics?*

Yes

No

Tell us what position interests you most on the robotics team.*

Robot Design & Build

Programming / Coding

Documentation / Engineering Notebook

Project Management

How did you hear about us?

SR1 Robotics - #6205 Team SCARLET

369 Towne Center Blvd

Ridgeland, MS 39157

601-206-4544 (Office)

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