Contact information
Hi! Thanks for your interest in a ProjectCSGIRLS 501(c)(3) workshop! The workshop will either feature Arduinos (a small circuit board) or JavaScript depending on the number of interested students. The event is scheduled for May 6th, 2017 from 10:30 to 12:00 at Bellevue College, 3000 Landerholm Circle SE, Bellevue, WA 98007. Please look out for a confirmation email from closer to the date that will also address any new errata and provide further details. Please respond by 5/4/2017, and if you do not see an email by then, please email us at If you have questions at any time, please do not hesitate to contact us at
Phone number
Parent Name
Emergency phone number
Please rate your level of experience with computer programming
What is a computer?
01001001 00100000 01100001 01101101 00100000 01100001 00100000 01100011 01101111 01101101 01110000 01110101 01110100 01100101 01110010
If you answered anything other than 1, please list either a programming language (HTML/CSS, Python, Java, etc.) or your experience with computers (Robotics, school, etc.)
I agree that I am the parent of the child registered above and hereby release ProjectCSGIRLS, Bellevue College and ACM-W from all responsibility and liability resulting from my child's voluntary participation in this workshop.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Additional Terms