Girls Coding and Robotics Camp Application

Girls Coding and Robotics Camp Application

Presented by Jersey Shore Women in Tech & Geek Speak
This application is for the opportunity for high school girls to be selected to attend an 8-week coding camp at Plum Crazy Robotics in Marlboro, NJ. Classes will be held 1 day per week for 8 consecutive weeks and be 90 minutes each.

Students need no prior experience and will have the opportunity to learn various Programming languages through the use of Raspberry Pi's, Arduino's, 3D Printing, Gaming, Electronics, Robotics, and more! Students will be able to choose their trajectory depending on which is most appealing to them and may go at their own pace.

If selected, all tuition costs will be covered through donations collected, and students will also have a take-home kit purchased for them so they can continue to work on their skills between classes and after the camp has ended.

If students are unable to drive to the camp or get a ride, we can arrange transportation at no cost to the student as part of the sponsorship.

Deadline for submissions is January 31st, 2018. Selections will be announced in Febuary 2019.

Any questions should be forwarded to jerseyshorewomenintech@gmail.com.
Student Information
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
About Parent/Guardian
Name of Parent/Legal Guardian*

First NameLast Name
Phone Number of Parent/Legal Guardian*

Area CodePhone Number
Email of Parent/Legal Guardian*
example@example.com
About You
Tell us about yourself and why you'd like to attend this camp.*
Do you have any experience in coding or robotics? If so, what is your experience? (This does not affect your chances of acceptance. It is only informational so we can best serve you if you are selected.)*
Reference
Reference (Must be a non-related adult. I.e. Teacher/Librarian/Community Leader/Etc.) *

First NameLast Name
Reference Email*
example@example.com
Reference Phone Number*

Area CodePhone Number
Please provide a paragraph from your reference in their words as to why they believe you are a great candidate for this camp. *
Transportation

This does not affect eligibility. It is for organizational purposes only.
Select all that apply

I have or can get transportation to and from class in Marlboro, NJI can get transportation one way to classI can take an NJ Transit train to and from Aberdeen train station after schoolI can take an NJ Transit bus to and from Freehold Mall after schoolOther
Compliance of Student
If selected, I commit to 90-minute camp classes once per week for 8 consecutive weeks (dates to be determined) at Plum Crazy Robotics in Marlboro, NJ, barring any unforeseen emergencies.
Signature of Student*

Clear
Compliance of Parent/Guardian
The camp is located in Marlboro, NJ. If students are unable to drive or get transportation to class by car, they can take the NJ Transit train to Aberdeen Train Station or the NJ Transit bus to Freehold Mall, and a car ride to and from class can be provided from that station or stop by a volunteer from one of our organizations. If this ride is needed, once selected, arrangements will be made at that time and a permission slip must be signed by a legal guardian if the student is under 18.
I have read and understand the entirety of the application. I permit the applicant, if selected, to attend Plum Crazy Robotics 90-minute camp classes, once per week for 8 consecutive weeks (dates to be determined).
Signature of Parent/Legal Guardian*

Clear
Should be Empty:

Girls Coding and Robotics Camp Application

Student Information

About Parent/Guardian

About You

Reference

Transportation

Compliance of Student

Compliance of Parent/Guardian