Application - deadline June 15, 2019
Requirements: Ages 13 - 18, Available 7/8 - 7/19, Live in Prince George's County MD

The program will be held at Prince George's Community College

Parent(s) / Guardian(s) Name *
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Participants First Name *
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Participants Middle Name
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Participants Last Name *
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Street Address *
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City *
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State *
Zip Code *
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Home Phone (parent / guardian)
Your answer
Cell Phone (parent / guardian)
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Email Address (parent / guardian) *
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Date of Birth *
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Gender *
Race *
Education *
Name & Address of Last School Attended *
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Technology Interests (Check all that apply) *
Required
Describe your experience level in chosen area(s) of interest *
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How did you hear about the program?
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I am interested in participating in the summer workshops, and I will commit to attending all sessions. *
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