Form
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Will you be attending Code/Art Fest (March 15, 2025) and accept the travel stipend to help cover your travel expenses to attend the conference?
*
Yes - I will be there and I accept the stipend
No - I can't make it
What's your race/ethnicity?
*
American Indian or Alaskan Native
Asian or Asian American
Black or African American
Hispanic or Latinx
Native Hawaiian or Other Pacific Islander
White or Caucasian
Mixed Race
Gender
*
Female
Male
Non-binary
Prefer to Self-Describe
What is your current college level?
*
Freshman
Sophmore
Junior
Senior
What college/university do you currently attend?
*
Where do you currently reside? (City,State)
*
What is your intended or current major?
*
Which Code/Art programs have you participated in:
*
Code/Art Club
TA and/or Instructor
Code/Art's Coding Competition
High School Code/Art Intern
Volunteer
Other
Have your previously attended Code/Art Fest?
*
Yes
No
Don't Remember
Submit
Should be Empty: