California Campus Camp 2022 Participant  Registration Form
All camp participants must fill out this form to get the no-cost link to participate.

Participants who also want 4 units of academic credit must separately apply and pay for college credit through De Anza College. See directions at the bottom of this form below.

Registration for this year's all-digital Campus Camp is 100% free! Thursdays, 6-9 PM from Feb 3 to March 24.

Contact TeamCaliforniaCampusCamp@gmail.com for more information about either class and/or to get an add code. More info and directions at: https://cacampuscamp.com/college-credit/
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First Name *
Last Name *
Student ID number (if you are a Foothill-De Anza Student)
Best Email to Reach You *
Best Phone Number to Reach You *
(123) 456-7890
Does this phone accept text messages? *
Street Address *
City *
Zip Code *
Name of your College *
Major/ Minor (please mention if you haven't decided on a major yet). If faculty, your teaching discipline. If staff or ADMN, your area of service. *
Your role on your campus (if not campus-based, choose "other") *
Leadership Title(s)/Job Title(s), if any.
What should we know about your campus role, special areas or roles in leadership, work in the community, etc.?
On a scale of 1 to 10, how experienced are you as a community organizer, activist, leader with 1 being relatively new and 10 being the opposite of this. *
Please share any details about your numerical response above regarding your experience that you think would be helpful for us to know. In particular, tell us about issues you are currently working on and what ORGANIZATIONS or NETWORKS you are working with or belong to (e.g. your student government, clubs, Academic Senates, labor unions, SSCCC, etc)
The issues I am most interested in working on are... *
Pick no more than 4, please.
Required
Please collaborate and share! We encourage you and other camp participants to collaborate in your organizing. Which of the following items do we have your permission to share with other camp participants in order to help you and others at the camp connect? Please check all items we can share with other participants: , campus, role on campus, discipline or area of study/work, email, phone, photo of yourself, campus and/or community organizations you belong to, key issue areas you are working on and/or are interested in? *
Required
We will be recording some sessions for training and publicity purposes. Some of these recordings may include your image and or other participation. Please give us your consent to use such images or other content. *
Required
To sign up for 4 units of De Anza College academic credit, please go to https://cacampuscamp.com/college-credit/ for directions.
Is there anything else you think we should know?
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