Free Web Dev Bootcamp (5 Weeks)
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Why are you interested in learning web development? *
First Name *
Last Name *
Email *
Date of Birth *
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Were you affected by COVID-19? *
If yes, please let me know how?
About you
These questions are my way of understanding who I am serving in the classroom. None of this will ever be published or shared in a way that it can be tied back to you.

Gender *
With which race / ethnicity do you most identify? *
What's your highest level of education? *
How did you hear about the class? *
Do you require any accommodations in the classroom?
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If yes, please let me know how I can best help you in classroom.
Anything else I should know about you?
Since this class will be conducted virtually and recorded, I need permission to record your voice and possible image. By selecting yes, you agree to be recorded in the context of this class. *
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