Girl Code Application
Girl Code is a camp for young teen girls to explore their self-identity through gained knowledge of opportunities in the engineering field and skills in coding, collaboration, and critical thinking. Through their self-exploration, these young girls will challenge the established social labels placed on women in engineering and forge a new path of their own. *Open to girls currently attending school in Porterville Unified and entering 8th grade in the 2018-2019 school year.
Application Window
We are only accepting applications from April 30, 2018 at 3:00pm till May 5, 2018 at 3:00pm.
Spaces are limited and filled on a first-come, first-serve basis.
Student Information
Student's Name (First name, Last name) *
Your answer
Date of Birth *
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YYYY
Student ID Number (if known)
Your answer
Student E-mail address *
You can give your personal email address; but if you do not have a personal email, use your mypusd.org account.
Your answer
Student Phone Number
Your answer
Parent/Guardian Information
Parent/Guardian Name (First and Last name) *
Your answer
Parent/Guardian's Relation to the Student *
Parent E-mail address
Your answer
Mailing Address *
Include street number, street name, city, state, and zip code
Your answer
Parent's home/cell phone number *
Your answer
Home address (if different than mailing address)
Your answer
Alternate/Emergency phone number *
Your answer
Current Middle School *
Medical Information
Do you have any medical conditions? *
If yes, explain your medical condition
Your answer
Do you require daily medication? *
If yes, please explain.
Your answer
Do you have any allergies? *
If yes, please give details about all allergies.
Your answer
Experience
Do you have experience with coding or technology beyond daily use (camp, club, team, class, etc)? *You do not need experience to be accepted. *
If yes, please explain your experience.
Your answer
Signature
Digital Signature *
I am supportive of my child's request to attend Girl Code Summer Camp. I am dedicated to my daughter's attendance to all three days of the camp. I certify that the information provided is complete and correct to the best of my knowledge.
Type your name for your digital signature *
Your answer
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