Fall 2021 Registration Form 2021-2022
Welcome to another great year of programming and events with the Iribe Initiative for Inclusion & Diversity in Computing (I4C) and the Maryland Center for Women in Computing (MCWIC). Your child's safety is our number one priority. Although we will continue to offer programs as virtual experiences, there will be a few opportunities for children 12 and older who are fully vaccinated to join us on campus. As we receive guidance from university, county, and state officials concerning your child's safety for in-person activities, there may be some adjustments to our plans.
Please complete this registration form as soon as possible to ensure your space in our programs. The questions are for internal use within I4C/MCWIC. None of your personal identifiable information will be disclosed to third-party agencies.
If you have any questions or concerns please feel free to contact us at (301) 405-7615 or send an email to
. Check our website for upcoming events:
and receive our Outreach Newsletter by joining our listserv:
Sign in to Google
to save your progress.
Parent or Guardian First & Last Name
Parent or Guardian Email Address
Parent or Guardian Phone Number
Please exclude spaces and dashes.
What state do you live in?
District of Colombia (DC)
What city or ward do you live in?
Note: If you live in the District of Columbia please share the Ward you live in.
Parent's Highest Level of Education
High School diploma
GED or alternative
Some college, but less than 1 year
1 or more years of college credit, no degree
Prefer not to disclose
Page 1 of 8
Never submit passwords through Google Forms.
This form was created inside of University of Maryland, College Park.