ETS Program Application

ETS has certain eligibility requirements.
Please use only numbers, or if you do not have a Social Security number please write "N/A".
Please only use numbers. Include area code and phone number.
Select one or more options.
Cal Poly encourages inclusivity in all its programs and activities. If you anticipate needing any type of accommodation, including (but not limited to) physical access or Deaf/Hard of Hearing services, or adapted materials, please call Educational Talent Search at 805-756-7480 in advance of your participation or visit.
    
Parent Information
Please use only numbers and include the area code.
Please use only numbers and include the area code.
Please use only numbers and include the area code.

Please read and enter your name below signifying that you agree with the following statement:

I/We give permission to the Educational Talent Search (ETS) program at Cal Poly to access any school or financial records of my student to determine: eligibility for the program; status and progress in middle, secondary and post-secondary education; and eligibility for financial aid. In addition, I give my permission for my child's name, photograph, work and/or statements to be used by ETS for promotional, publicity or instructional purposes in print and/or electronic formats. 

My student has the permission to participate in field trips planned for and supervised by ETS. Furthermore, should my student require medical attention and/or care while participating in ETS, I give my consent to medical examination and necessary treatment, including drugs, x-rays, and surgery as may be deemed necessary by the attending physician. This consent shall remain effective so long as my student is a participant in ETS. Should an emergency arise, staff will attempt to reach me and be guided by my wishes. In the event that I cannot be contacted, the attending physician has my consent to act as medical judgment may indicate. 

All information provided in this application is accurate to the best of my knowledge. 

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