2024 GenCyber Gateway to Cyber Summer Camp Application

GenCyber "Gateway to Cyber"
Summer Camp Application

Simply respond to the following questions (including a very brief essay and a teacher's name and email address whom we can contact to get a recommendation letter in support of your attending the camp).

Applications must be submitted by June 15, 2024. The essay and teacher recommendation letter should be emailed directly to GenCyber Program Director Dr. Raymond Albert at rt.albert@assumption.edu by this date.

Questions should be directed to GenCyber Program Director Dr. Raymond Albert at rt.albert@assumption.edu

All fields marked with * are required and must be completed.
Camper Information
Name *

First NameLast Name
Age*
Grade Entering Fall 2024*
Gender
Tee-Shirt Size*
Do you reside in the Massachusetts and attend high school)?*
Race / National Origin (check all that apply)

American Indian or Alaskan NativeAsian or Pacific IslanderBlack, not of Hispanic originHispanicWhite, not of Hispanic origin
Street Address*
City*
State*
Zip Code*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Do you have access to the Internet and a computer?*
Do you have any food allergies?*
Have you attended a GenCyber camp before?*
If yes, which camp did you attend and when was it?
Do you agree to commit to working on pre-camp and post-camp activities?*
Please describe any cybersecurity experience you have (none required).
How did you learn about this opportunity?
Parent / Guardian Information
Name*

First NameLast Name
Parent / Guardian Email*
example@example.com
Parent / Guardian Phone Number (including area code) *
High School Information
High School Name*
High School Street Address
High School City
High School State
High School Zip Code
Recommending Teacher
Teacher Name

First NameLast Name
Teacher Email*
example@example.com
High School*
Release Form

Please download the photo release form. Read, sign, and have your parent/guardian read and sign the form. A few group photos will be taken at the camp, and we need permission to share.
File Upload

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I hereby certify that all the information that I am submitting is correct.
Name*

First NameLast Name
Date

MonthDayYear
Date
Should be Empty:

GenCyber "Gateway to Cyber" Summer Camp Application

Camper Information

Parent / Guardian Information

High School Information

Recommending Teacher

Release Form

I hereby certify that all the information that I am submitting is correct.

GenCyber "Gateway to Cyber"
Summer Camp Application