STEAM CAMP Online Registration Form

NAACP STEAM College Connections 2020 Online Registration

Please fill in the form below. We'll contact you as soon as possible.
Student Full Name*

First NameLast Name
Grade Entering (Fall)

4th5th6th
Gender

MaleFemaleOther
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent's E-mail*
E-mail
example@example.com
Phone Number*

Area CodePhone Number
First time to attend this camp*

YesNo
Select Chess Option:

BeginnerIntermediateAdvanced
Which is your preferred coding class (select one)

Coding Fundamentals (Beginner coding)Coding Beats Club (Hip Hop/) (Intermediate/Advanced coding)Game DesignOther
You will need access to the following (check all that apply)

I have access to a laptop, chromebook/IPADI have access to the internetI do not have access to a laptop, chromebook/IPADI do not have access to the internetOther
My Products
prevnext( X )
Camp Registration Fee (Reg. $250)$100.00

Scholarship Assistance (answer following question)$25.00

Total $0.00
Please indicate hardship?

Free Reduce LunchLoss of IncomeOther

NAACP STEAM College Connections 2020 Online Registration