GenCyber Camp Registration Form 2023

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Thank you for your interest in GenCyber Camp a week-long commuter event, June 19-23, 2023.

Please complete the information below to apply for a space at the

Deadline for applications will be Friday, May 12, 2023.

First name *

Last Name *

School District Name *

School Name *

Email (If you don't have an email, list your parent's email address) *

Student Cell Phone Number *

Name of Parent (first and last name) *

Cell Phone for Parent *

Parent Email *

Please give the first and last name of an emergency contact, other than your parent or guardian listed above. *

Please provide a cell phone number for your emergency contact. *

What is your current grade level in school? *

6th grade

7th grade

8th grade

What is your gender? *

Female

Male

T-Shirt Size *

Extra Small

Small

Medium

Large

Extra Large

XX Large

XXX Large

Other:

Required

What computer science classes have you taken? (Select all that apply) *

Cyber Foundations

Computer Science & Engineering (CSE)

Exploring Computer Science (ECS)

I have not taken any computer science courses.

Other:

Required

Please provide a brief description of why you want to attend this camp and what you hope to learn during the camp. *

How will you get to and from camp? *

My parent/guardian will bring me and pick me up

I will ride with a friend

I don't know yet

Other:

I understand that this is a commuter camp and no overnight accomodations will be provided. I will need transportation to the camp each morning by 8:00am and will need to be picked up by 5:00pm each day. *

I understand.

This isn't possible for me so I will not be able to participate in the camp.

Do you have a laptop computer which you can bring with you to the camp? *

Yes

How did you hear about the camp? *

Mississippi State University website

Classroom teacher

Friend

Other:

Please list any allergies or special dietary needs, if applicable. Put N/A if there are none. *

I understand that once I have checked-in for the camp I will be under the supervision of camp staff and I will comply with all rules and regulations of the camp and Mississippi State University. This includes but is not limited to staying with my group during the entire duration of the camp, not having guests at the camp facilities who are not participating in the camp, not leaving the MSU campus at any time during camp hours. *

I understand and will comply.

I choose not to attend this camp.

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