Connect Week at SupplyFrame - Coding For Treasure
Wednesday, October 19th

30 E Del Mar Blvd,
 Pasadena, CA 91105
(626) 793 - 7732
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Student's First Name *
Student's Last Name *
Student's Age *
Student's Gender *
Student's Grade *
What school does the student attend? *
Has the student attended a STEAM:CODERS Class, previously? *
Does the student have access to a computer, laptop or tablet at home? *
Does the student have internet access at home?
Parent/Guardian's First Name *
Parent/Guardian's Last Name *
Parent/Guardian's Email Address *
Parent/Guardian's Preferred Phone Number *
Emergency Contact's First and Last Name *
Emergency Contact's Preferred Phone Number
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