Girls Who Code - Loyola Club Registration
Spring 2019 Student Registration Form
Start Date: Saturday, Feb. 2
Time: 10:00am-12:30pm (maybe 12:00pm on certain days, we'll keep you posted)
Location: Crown Center Rooms 103-105 (1001 W Loyola Ave, Northeast corner of the Lake Shore Campus, Chicago, IL 60626)
Email address *
Student First Name *
Your answer
Student Last Name *
Your answer
Student Email Address *
Your answer
Student T-Shirt Size (Adult Unisex Sizes) *
Student Programming Experience (no experience necessary!) *
Your answer
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Parent/Guardian Phone Number *
Your answer
Parent/Guardian Email Address *
Your answer
Emergency Contact First Name *
Your answer
Emergency Contact Last Name *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Email Address *
Your answer
School Name *
Your answer
Grade in School *
Allergy Information *
Your answer
Any additional information for us?
Your answer
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