2017 Middle School Girls Computer Science Camp
Email address *
Parent/guardian information
Parent/guardian's first name *
Your answer
Parent/guardian's last name *
Your answer
Parent/guardian's e-mail address *
Your answer
Day time phone number *
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Evening phone number *
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Mailing address *
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Relationship to student *
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Highest education attained *
Student information
Student's first name *
Your answer
Student's last name: *
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Student's birthday *
mm/dd/yyyy
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Student's school (for fall 2017) *
Your answer
Student's grade level (for fall 2017) *
Student's ethnicity *
Required
Does student receive free or reduced lunch and/or is yearly family income at or below $40,000? *
T-shirt size *
Student's most recently completed math course *
Your answer
Please describe any experience with computer science or programming or web design that the student has (answer to be written by the student.)
Your answer
Why are you interested in attending this camp? (answer to be written by the student.)
Your answer
How did you hear about our camp? *
Required
Friends
If any of your student's friends are also applying for camp, feel free to list them here so we can try to place them in the same session.
Your answer
Please let us know of any accommodations needed for the student
This will not be used to determine admission to camp
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A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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