PA Homeschoolers Intro to Computer Science Application
This application is intended for homeschooled students who are interested in taking Intro to Computer Science with Ms. Rebekah Lang for the 2020 - 2021 school year. Please complete all required sections of the form to help me understand your interest and relevant experience. If you have any additional questions or concerns, please email me at
Email address *
Student's First Name *
Student's Last Name *
Student's Gmail Address: *
You may share my name and email address with others in the class so we can collaborate and work together! *
Student's Gender: *
Student's Race/Ethnicity (check all that apply): *
Parent/Guardian's First Name *
Parent/Guardian's Last Name *
Parent/Guardian's Relationship to Student: *
e.g.: mother
Parent/Guardian's Email Address: *
Complete Mailing Address: *
e.g.: Geoffrey Butler, 508 St Cloud Rd, Los Angeles, CA 90077
Student's Phone Number: *
Parent/Guardian's Phone Number: *
Student's Date of Birth: *
What year of school will you be completing 2020-2021? *
What type of of computer will you be using for the class? *
What operating system does your computer use? *
What are your goals for the class? *
List your prior experience with computer science, programming, coding, etc. *
(If you have none, it's ok to write that too).
Briefly describe your prior experience and comfort level with distance/online learning. *
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