2016 Midland Student Symposium Application

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Student Information
1.  Please complete the application below to apply for the 2016 Midland Student Symposium. For more information on the program, visit www.billofrightsinstitute.org/engage/students-programs-events/midland-symposium/.
2.  The red * means that the field is required.  
3.  Contact Kate Gaziano if you have any questions at kgaziano@billofrightsinstitute.org 












To comply with legal requirements, we must ask for your birthdate.
School Information


Please enter a 4-digit year (example: 2015)




Parent/Guardian Information




Referring Teacher Information
Please include the contact information for a social studies teacher (history, government, civics, economics, etc.).  We may contact this teacher to provide a reference for you.


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More Information About You







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Essay Questions
Please answer the following questions. We recommend that you type your responses in another program and then copy and paste each essay in the appropriate text box so that the page does not time out.  


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