Code4Life Student Sign-In
You are participating in the Code4Life program. The form below will help us communicate with you and gather your feedback. If a question has an "*" by it, the question is mandatory. If you don't know the answers to the other questions, leave them blank.
First Name *
Your answer
Last Name *
Your answer
Email Address
Your answer
Cell Phone Number (XXX) XXX-XXXX
Your answer
School Information
School Name *
Your answer
Grade *
What Module of Code4Life are you learning this semester? (If you're not sure, ask your instructor) *
Parent Information
Parent First Name *
Your answer
Parent Last Name *
Your answer
Parent Email
Your answer
Parent Phone (XXX) XXX-XXXX
Your answer
Questions
How did you hear about Code4Life? *
What would you like to learn from Code4Life? *
Your answer
What is your favorite subject in school? *
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