Request Information Form

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Address that information should be sent to
* First Name:
Middle Name:
* Last Name:
* Address:
* City:
* State:
* Zip:
Home Phone:
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Email Address:
Please check information requested
Elementary Student Talent Search EXPLORE Testing (grades 3-6)
Pittsburgh Weekend Workshops (grades K-9)
Lower Merion (near Philadelphia) Weekend Workshops (grades 2-7)
One- and two-week Summer Program (grades 3-8)
August Steppingstones classes (grades 1-9)
Professional Development Workshops for Educators
Additional Information
Are you a teacher or school administrator:	Yes No
Student Grade Level:	K 1 2 3 4 5 6 7 8 9
Comments or Other Information:

Contact Information:
C-MITES, Carnegie Mellon University, Margaret Morrison St., MMP 30, Pittsburgh, PA 15213, Phone: (412) 268-1629, Fax: (412) 268-1049, Email: cmites@cmu.edu