2023 Fly-In Interest Form Thank you for your interest in Harvey Mudd College! Complete this form to learn more about the Future Achievers in Science and Technology (FAST) and Women's Inclusion in STEM (WISTEM) program. FAST and WISTEM are free, fly-in programs for high school seniors and juniors who are U.S. Citizens or permanent residents living in the US. We'll be in touch when more information becomes available. You can also review the FAST and WISTEM websites for updates. *Indicates a required fieldStudent's InformationStudent First Name*Student Preferred First Name (We will use this name in future communications and event name tags, if applicable)Student Last Name*Student Birthdate*Student Birthdate*JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember12345678910111213141516171819202122232425262728293031202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619251924192319221921192019191918191719161915191419131912191119101909190819071906190519041903190219011900Sex*FemaleMaleX or another legal sexStudent Email Address*Confirm Student Email Address*Mobile Phone*Mobile Phone (hidden)Mobile Phone (hidden)College Email AccountEmail AddressEvening PhoneMobile PhonePrimary PhoneMay we text you?* It is unlikely that we would text you beyond the scope of this event until you become an HMC applicant.May we text you?* It is unlikely that we would text you beyond the scope of this event until you become an HMC applicant.YesNoStudent Address*Student Address*CountryStreetCityRegionPostal CodeCurrent School* (Search using your school name or CEEB code, "not found" option also available)CEEB (Hidden)I plan to apply to college as a*First YearTransferI plan to enroll for this term*Fall 2025Fall 2026Fall 2027Fall 2028Fall 2029Program InterestWhen more information becomes available, I would like to be emailed about: (select all that interest you)*When more information becomes available, I would like to be emailed about: (select all that interest you)*Future Achievers in Science And TechnologyWomen's Inclusion in STEMOptional InformationI identify my gender asPrimary CitizenshipAfghanistanAland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAshmore and Cartier IslandsAustraliaAustriaAzerbaijanBahamas, TheBahrainBangladeshBarbadosBassas Da IndiaBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius, and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandClipperton IslandCocos Islands (Keeling Islands)ColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCoral Sea IslandsCosta RicaCote D'IvoireCroatiaCubaCuracaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaEuropa IslandFalkland Islands (Islas Malvinas)Faroe IslandsFederated States of MicronesiaFijiFinlandForeign/UnknownFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGambia, TheGaza StripGeorgiaGermanyGhanaGibraltarGlorioso IslandsGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong Kong S.A.R.HungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJan MayenJapanJerseyJordanJuan De Nova IslandKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacau S.A.R.Macedonia, Republic of NorthMadagascarMalawiMalaysiaMaldivesMaliMaltaMan, Isle ofMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorwayOmanPakistanPalau, the Pacific Islands ofPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSpratly IslandsSri LankaSudanSurinameSvalbardSvalbard and Jan MayenSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTromelin IslandTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis and Futuna IslandsWestern SaharaYemenYugoslaviaZambiaZimbabweDo you identify as Hispanic or Latinx?YesNoRace (Check all that apply)Race (Check all that apply)American Indian or Alaska NativeAsian or Asian AmericanBlack or African AmericanNative Hawaiian or Other Pacific IslanderWhiteFirst Generation-College BoundFirst Generation-College BoundYes - None of my parent(s)/guardian(s) have graduated with a Bachelor's degree from a 4-year institutionNo - At least one of my parent(s)/guardian(s) have graduated with a Bachelor's degree from a 4-year institutionDo you (or your family) qualify for or participate in any of the following? ACT or SAT testing fee waiverFederal Free or Reduced Price Lunch program at schoolFederal, state or local programs that aid students from low-income families (eg. TRIO programs such as Upward Bound)Income Eligibility Guidelines set by the USDA Food and Nutrition ServicePublic assistanceDo you (or your family) qualify for or participate in any of the following? ACT or SAT testing fee waiverFederal Free or Reduced Price Lunch program at schoolFederal, state or local programs that aid students from low-income families (eg. TRIO programs such as Upward Bound)Income Eligibility Guidelines set by the USDA Food and Nutrition ServicePublic assistanceYesNoI would describe my community setting as:I would describe my community setting as:RuralSuburbanUrbanUnknownIntended Major(s): (Check all that apply)Intended Major(s): (Check all that apply)BiologyChemistryComputer ScienceEngineeringMathematicsPhysicsJoint Major in Chemistry and BiologyJoint Major in Chemistry and ClimateJoint Major in Computer Science and ClimateJoint Major in Computer Science and MathematicsJoint Major in Computer Science and PhysicsJoint Major in Mathematical and Computational BiologyJoint Major in Mathematics and PhysicsIndividual Program of StudyOff-Campus MajorUndecidedSubmit