First Name:*
Last Name:*
Middle Initial:*
Parent/Guardian's name:*
Phone:*
Email:*
Home Address:*
City:*
State:*
Zip:*
Current School:*
Favorite Subject:*
School Address:*
Parents or Guardians of any students interested in being a part of "The Glimpse" can submit a brief application online with a typed statement not to exceed 500 words detailing their student's respective story as well as a specific area of interest and/or specific individual compatible with the program.:* Parent/Guardian Release Statement: I authorize the release of the above information as well as my personal essay for review by the Board of Directors for Impossible Possibilities. I am the parent or guardian of the student whose name appears on this application, and my student is currently enrolled at an elementary or middle school in the Dallas or Tarrant Counties. The information submitted is as accurate as possible, and I have by no means altered or falsified any personal data to increase the odds of my student being selected for "The Glimpse." I understand that the information provided in my personal essay will be included on the organization’s website if my student is selected. I allow Impossible Possibilities to use footage of my student from "The Glimpse" event for a mini-video documentary to be featured on the organization’s website. I understand that by checking the box below and initialing I have read and agree to the specifics of "The Glimpse" Release Statement. Initials:*