New SAME Application

SAME Application

Information (Must be a Monroe County Resident)

Thank you for your interest in the Summer Advanced Manufacturing Experience (SAME) Program. Please complete this application for each interested participant.

Eligibility is open to Monroe County students entering grades 9–12 in the 2026–2027 school year, provided they have successfully completed Algebra I and passed the Regents exam.

Application Deadline: Friday, May 29, 2026

Student Information

Please complete this section with interested participant information.

First Name

Last Name

Gender

Birth Date

Street

Mailing Street2

City

State/Province

Zip/Postcode

T-Shirt Size

School District Information

Grade

High School

High School Counselor

High School Transcripts

Current Report Card

Letter of Recommendation (Counselor)

IEP or 504 (if applicable)

Parent/Guardian Contact Information

The email provided below will be the email used for any communications related to the SAME Program.

Contact Name

Relationship

Cell Phone

Home Phone

Work Phone

Emergency Contact Information

Please provide at least one additional emergency contact.

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Cell Phone

Emergency Contact Home Phone

Emergency Contact Work Phone

Health Information

Please include all relevant medical information. This information will be reviewed by a nurse, and you will be contacted if there are any questions or additional information is needed. You can also email cwdinfo@monroe2boces.org for additional information or to provide necessary documents.

Any Medical Alerts?

Yes No Not Selected

Health Problems/Concerns

Do you have an existing care plan in place?

Yes No Not Selected

Hospital Preference

Medications taken at school?

Yes No Not Selected

If yes to meds, please list and explain any pertinent orders:

Any allergies to any substance?

Yes No Not Selected

If yes to allergies, please identify:

Need for Benadryl & Epi-Pen?

Yes No Not Selected

Additional Ben/Epi Information

Thank you

Monroe 2-Orleans BOCES
Center for Workforce Development