Saturday Meet-ups

Student Information

• Name
  First Last
• ZIP Code
• Phone Number
  ###-###-####
• Email
• Preferred Pronouns
  she/her/hers, he/him/his, they/them/their
• High School
• Graduation Year
  Class of 2019, Class of 2020, Class of 2021, Class of 2022
• Are you interested in launching a CoderSpace at your school?
  Yes, No
• How did you hear about CoderSpace?

Primary Family Contact

Please share the name and contact information for the adult member of your family who signs your permission forms.

• Name
  First Last
• Relationship
• Phone Number
  ###-###-####
• Email