Space Trek Application Student Name:* Current Age:* Date of Birth:* Student Phone:* ( ) - Second three digits Last four digits Student Email:* Mailing Address:* Current School:* Current Grade Level:* T-shirt size:* Please indicate if this is a youth or adult size.Parent/Guardian Name (1):* Parent/Guardian Phone (1):* ( ) - Second three digits Last four digits Parent/Guardian Email (1):* Parent/Guardian Name (2): Parent/Guardian Phone (2): ( ) - Second three digits Last four digits Parent/Guardian Email (2): Are you a Youth Career Connect (YCC) student?:* YesNo If yes, please provide the name of your YCC career counselor: If yes, please provide the email address of your YCC career counselor: Why do you want to attend SpaceTrek? (Please upload 1000 words or less):* Upload coupon: Take a pic or scan your coupon and upload the file here.