Parent Permission Form

  • Your son/daughter has been invited to participate in New Mexico Mathematics, Engineering, Science Achievement, Inc. NM MESA, Inc., is an educational program designed to encourage and prepare students for college majors and careers in mathematics, engineering, science and related fields. NM MESA, Inc. assists these students by offering the following and more:

    Rigorous Academic Schedule • Weekly Tutoring • Field Trips • Competitions • Academic & University/Career Counseling • Leadership Workshops

    Participating students receive the educational enrichment experiences and practical help they need to achieve academic excellence and prepare for college. NM MESA, Inc. is a very successful program - 78% of MESA graduates go on to college or a university and 49% have chosen majors in math, engineering or science.

    Please read the minimum requirements for membership and the minimum requirements necessary to receive a Loyalty Award. Once you have done that, please sign and submit this form. A copy of this form will be kept on file in the NM MESA, Inc., offices.
    Note: Your child is eligible to earn up to $1000 for college, based completion of the Loyalty Award requirements.

    Yearly membership requires the following:

    • Submit Parent Permission Form (A-1) to MESA Advisor.
    • Enter your Student Profile Form (A-2) online or submit the paper form to MESA Advisor. Student information will be entered into MESA Information Management System (MIMS).
    • Demonstrate a high standard of behavior while participating in NM MESA events.
    • MESA students that participate in illegal activities such as, but not limited to, possession or consumption of alcohol and/or drugs, theft, or vandalism, relinquish their current and future membership in NM MESA, Inc.

    High School Loyalty Award (LA) Guidelines

    In addition to the requirements above, MESA members must complete the following requirements to be eligible for the Loyalty Award:

    • Active membership in MESA for 2 years including first semester of senior year is required for students to receive an award.
    • Apply online in March for award after receiving notification if eligible.
    • Complete 4 credits of college preparatory math and English and 3 credits of science upon high school graduation.
    • Have a minimum ACT score of 18 OR a minimum SAT score of 870 OR a 2.8 weighted GPA
    • Have a minimum of 175 points in MIMS
    • Submit a schedule of classes from an accredited college or university.
    • Provide a brief testimonial of your MESA experiences.
    • Provide a social security number, green card number, or tax identification number.

    Please note the following:

    • Member and parent/guardian agree that NM MESA, Inc. is the final authority on Loyalty Awards.
    • Member’s grades and test scores are verified by an official high school transcript.
  • If you're uncertain, please view the region pages on NM MESA's website.
  • MESA students that participate in illegal activities such as, but not limited to, possession or consumption of alcohol or drugs; theft, or vandalism, relinquish their current and future membership in NM MESA, Inc.

    I am pleased to have my child participate in NM MESA, Inc. I have read, understand and agree to the minimum requirements for participation in the MESA program and the Loyalty Award. I give permission to NM MESA, Inc., and its funding agencies, to acquire information regarding my child's academic performance including PED number, school transcripts, and test results. I also give permission to use my child's photograph in press releases, newsletters, reports, video, website, social media and any other documentation used by NM MESA, Inc. I hereby certify that the information on the student profile (A-2) is accurate to the best of my knowledge.

  • Date Format: MM slash DD slash YYYY
  • I have read, understand and agree to the minimum requirements for participation in the MESA program and the Loyalty Award.

  • Date Format: MM slash DD slash YYYY
  • Note: A copy of this form will be kept on file with NM MESA, Inc. Please contact your MESA Advisor with any questions or concerns.

  • This field is for validation purposes and should be left unchanged.
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