GenCyber Girls at Coastline 09/14/19 - Event Application
Seats are limited! Please be sure you are interested in attending the entire week of camp before submitting the application.

WHERE: Coastline Community College, 12901 Euclid St, Room 315, Garden Grove
WHAT: GenCyber event for youth girls to experience cybersecurity challenges and talk to IT professionals
WHEN: Sat 09/14/19 9:00AM-2:00PM
WHO: Youth girls, 7th grade to 12th grade, that previously attended GenCyber Girls Summer Camp
COST: Free
ORGANIZER: Professor Tobi West, CIS Dept Chair, Coastline College, SoCalCCCC

QUESTIONS? Feel free to contact me by email at twest20@coastlne.edu

Lunch, water, and snacks will be provided. Please make appropriate arrangements for transportation.

Qualified applicants will be notified of acceptance in early September.

Email address *
Your Name (first & last name) *
Your answer
Your Grade [as of fall 2019] *
Under 13? Have your parent complete the form.
Parent/Guardian's Email *
Please do not use a Yahoo email address, these seem to have issues with blocking email from Coastline.edu
Your answer
Parent/Guardian's Phone Number *
Please provide a number where we can reach a parent/guardian in case of emergency.
Your answer
You understand that you must have your parent's permission in order to attend? *
Required
Your school's name & city [as of fall 2019] *
Your answer
Attended any of these cybersecurity events at Coastline College in the past? *
Please complete this form only if you previously attended GenCyber Girls in July 2019 at Coastline College
Required
What types of activities do you enjoy in your spare time? *
Your answer
Any dietary restrictions? *
Your answer
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