GWC Interest Form

Girls Who Code at Rock Valley College Interest Form

* Indicates required field

Are you an interested parent/guardian or 6th-12th student? *

I am a parent I am a student Other

Choose one option

What is students name? *

First

Last

What is Name of one Parent/Guardian? *

If you are a student which grade are you in now? *

6th 7th 8th 9th 10th 11th 12th College (Who like to be a TA)

What is the name of the school you (if you are a student) or your child (if you are a parent) currently attends? *

Please provide the email address by which it is best to reach you at: *

How did you hear about Girls Who Code-Rock Valley College? *

Which Upcoming Cohort Are You Interested in Attending *

Spring 2018

Other Comments *

Submit