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SENIOR INTERNSHIP PROGRAM FORM
AUGUST 16TH - 27TH 2021
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* Indicates required question
CHILD'S DETAILS
Applicant's Name
*
Your answer
Date Of Birth (dd/mm/yy)
*
Your answer
Home Address
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
PARENT'S DETAILS
Name
*
Your answer
Address
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
EMERGENCY CONTACT
Name
*
Your answer
Phone Number
*
Your answer
Relationship
*
Your answer
Kindly Indicate Knowledge Level as Applicable
SCRATCH
*
NONE
BASIC
INTERMEDIATE
ADVANCED
Other:
JAVA SCRIPT
*
NONE
BASIC
INTERMEDIATE
ADVANCED
Other:
HTML
*
NONE
BASIC
INTERMEDIATE
ADVANCED
Other:
PYTHON
*
NONE
BASIC
INTERMEDIATE
ADVANCED
CONSENT: Pictures and videos from the event with your child in it may be used for promotional materials.
*
I AGREE
I DO NOT AGREE
I hereby undertake that all information provided above is correct.
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YES
NO
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