ctsRegistration.ContentModels.StudentRegistrationModel ctsRegistration.ContentModels.StudentRegistrationModel

STUDENT REGISTRATION

Tell us about yourself

Please fill out the following form to apply for the Junior High and High School Code to Success Program! Please note that our student capacity has been met and registration is closed for online enrollment and for several campuses.

Summer Program Dates: June 14th - July 23rd, 2021

Which program are you registering for?

Which course would you like to participate in?

Student First Name

Student Last Name

Student Phone

Student Email

Please check to verify the student email listed above is the student's personal email. This email will be used daily for the student to access the Code to Success curriculum. Yes, it is the student's personal email

Street Address

City

State

Zip Code

Country

Parent/Guardian Full Name

Parent/Guardian Email

Parent/Guardian Phone

By giving a parent/guardian phone number, you are agreeing to receive reminders and important program information via text and/or calls. I understand I may receive text or call communications

Coding Experience

What grade are you currently in?

What school district are you in?

What junior high or high school are you attending?

Would you like to register for the On-Line or On-Campus program?

What device(s) can you access to complete the coding course?

PC - desktop or laptop

MAC - desktop or laptop

Tablet/iPad

Chromebook

Please select your preferred campus

Have you participated in a Code to Success program before?

How did you hear about Code to Success?

Please check if you have read and agree to the Code of Conduct Yes, I have read and agree to the Code of Coduct

Shirt Size (adult sizes - not fitted)

Gender Identification

Please select a category that best represents you

Do you qualify for free or reduced lunch?