SILICON VALLEY FUTURE STARS ACTIVITIES

"A community that values its young ... invests in their future."

Future Stars Activities

SVAP Home

Tutoring, Homework Assistance & College Prep

Plateau or Enrichment

Workshops, Seminars & Community Service

Existing Future Stars

New Students

Policy & Procedure Commitments

Registration Form

Digital Audio Production

Video Game Production

3D Animation Production

Computer Basics & Internet Security

Program Evaluation

Future Stars Activities

Online Registration

"Please Note that the students are continuously develoing: desiging and updating the content of the web site as they learn. Please bear with us. Thanks:

Silicon Valley Future Stars

REGISTRATION FOR SV FUTURE STARS AFTERSCHOOL PROGRAM

Silicon Valley Future Stars program is an integrated and innovative afterschool program that focuses on youth cultural awareness and educational enrichment programs that include career training in technology, broadcasting and performing arts. The program is operated by Silicon Valley African Productions, a non-profit San Jose based organization. It is a well known fact that teenagers do not like to be seen going into a homework centers for assistance, but, they love instant positive rewards, publicity, high paying jobs, and television/media spotlights. So we use this enrichment program as an academic/civic commitment incentive, and innovation outlet/spotlight for paving a brighter future for the participants. The Future Stars program is to open to all middle School and high school students in the Silicon Valley of California. Please register by completing all sections!

SECTION ONE: Please Complete Participant Information

Indicate the activity or class that you are registering for:

Student Last Name:First Name: MI

Date of Birth: Gender: Ethnicity: Grade: GPA:

Address: City: State: Zip Code:

Phone: Cell: Email:

School: School District:

In addition to Tutoring, ACT/SAT and AP Test Preparation, Mentoring, Conferences and Workshops, community service, Internship and Work Experience, I am interested in (Check ALL interest)

Math, Science and Engineering Empowerment Cultural and Performing arts

Computer And Technology Access And Skill Development* Media Production and Broadcasting Skill Development: Graphics, Video, Simulations & Game Production

Job Readiness Development Leadership And Entrepreneurial Skill Development Recreational Activities

I certify that the information I have provided is true. I undertake to read and abide by the rules, regulations, policies and procedures of the Silicon Valley Future Stars program. I further commit to constant improvement of my academic performance to my maximum potential and sustaining excellence throughout my educational career.

Student Name: Student Signature: Date:

How did you hear about the program?

SECTION TWO: Please Complete Medical And Emergency Information

Participant’s Physician:

Physician’s Address: Telephone No.:

Medical Insurance: Group Number:

Subscriber’s Name: ID Number:

Employer’s Address:

Emergency Contact: Telephone No.:

Relationship to Participant:

SECTION THREE: Please Complete Participant's Guardian/Parent(s)Information

Guardian/Parent(s) Same Address as Student? YES / NO

Phone: Cell: Email:

Number of persons in your household:

Annual Household Income:$0 - $ 15,000 $15,000 - $25,000 $25,000 - $35,000 $35,000 - $50,000 Above $50,000

Highest Education: Occupation:

Job Title:Company: Location:

I certify that I am 21 years of age or over, and the information I have provided is true. I undertake to read and abide by the rules, regulations, policies and procedures of the Silicon Valley Future Stars program. I further commit to sustaining active participation in activities/programs that positively support excellence in my student’s education.

Yes. I am interested in being a parent volunteer.

I will donate $ in cash, every year, towards the success of the program.

Parent Name: Parent Signature: Date:

Thank you for your interest. Please note that you MUST read and sign the Program Policy and Procedure with the Media Authorization/Release, Liability Release, Medical Release and the Consent Letter to complete the registration.