2017 Camp Waitlist Form
Camp(s) interested in
Co-ed Middle School Intro to Robotics with Mindstorms
Co-ed Middle School Web Design
Co-ed High School Game Programming with Quorum
High School Girls Leadership in Tech Camp
Middle School Girls Creative Coding Camp
Parent/guardian's first name
Parent/guardian's last name
Parent/guardian's e-mail address
Day time phone number
Evening phone number
Relationship to student
Highest education attained
Some high school
High school diploma
Some 2-year college
2-year college degree
Some 4-year college
4-year college degree
Masters degree or higher
Student's first name
Student's last name:
Student's school (for fall 2017)
Student's grade level (for fall 2017)
Does student receive free or reduced lunch and/or is yearly family income at or below $40,000?
Women's Extra Large
Men's Extra Large
Student's most recently completed math course
Please describe any experience with computer science or programming or robotics that the student has (answer to be written by the student.)
Why are you interested in attending this camp? (answer to be written by the student.)
How did you hear about our camp?
UW Office of Minority Affairs & Diversity
If any of your student's friends are also applying for camp, feel free to list them here so we can try to place them in the same session.
Please let us know of any accommodations needed for the student
This will not be used to determine admission to camp.
A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
Page 1 of 1
Never submit passwords through Google Forms.
This form was created inside of UW Computer Science & Engineering.
Terms of Service