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Summer Coding Deep Dive
This form will help guide your conversation with Breakout Mentors Founder, Brian Skinner. It's okay to skip a question if you don't have a preference or you're not sure.
For questions, please email
info@breakoutmentors.com
or call 650-669-8789
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* Indicates required question
Parent/Guardian Information
Parent's name
*
Your answer
Parent's email
*
Your answer
Parent's phone number
*
Your answer
Home address
Your answer
As the parent or guardian, what are your goals? What are you hoping will be accomplished this summer?
Your answer
Student Information
Student's name
*
Your answer
Student's upcoming grade
*
Your answer
What school will the student be attending in the fall?
*
Your answer
What is the student's coding experience?
*
It helps to know any classes, camps, or online tutorials the student has completed.
Your answer
What are his or her goals (if any)?
Your answer
What are the student's hobbies or interests?
Your answer
Scheduling
What week would you like to start?
Your answer
When is the student available for sessions?
Available
Maybe
Unavailable
Weekday mornings (between 9am-12pm PDT)
Weekday afternoons (between 1-4pm PDT)
Weekday evenings (between 5-8pm PDT)
Weekend mornings (between 9am-noon PDT)
Weekend afternoons (between 1-4pm PDT)
Available
Maybe
Unavailable
Weekday mornings (between 9am-12pm PDT)
Weekday afternoons (between 1-4pm PDT)
Weekday evenings (between 5-8pm PDT)
Weekend mornings (between 9am-noon PDT)
Weekend afternoons (between 1-4pm PDT)
Clear selection
What is the preferred session frequency?
90 minute sessions (unless otherwise noted)
Yes
Maybe
No
2x per week (minimum 5 weeks)
3x per week (minimum 4 weeks)
5x per week (minimum 2 weeks)
3 hour sessions, 5x per week (minimum 1 week)
Yes
Maybe
No
2x per week (minimum 5 weeks)
3x per week (minimum 4 weeks)
5x per week (minimum 2 weeks)
3 hour sessions, 5x per week (minimum 1 week)
Clear selection
Please note any additional scheduling preferences or conflicts
Your answer
Preferences
Do you know the focus area you are interested in?
Yes
Maybe
No
Starting Coding - Python
Starting Computer Science - Python
AP Computer Science Preparedness - Java
Intermediate Web Development - Javascript
Starting Data Science - Python
Starting USACO Competition Coding - Java, C++, or Python
Other
Yes
Maybe
No
Starting Coding - Python
Starting Computer Science - Python
AP Computer Science Preparedness - Java
Intermediate Web Development - Javascript
Starting Data Science - Python
Starting USACO Competition Coding - Java, C++, or Python
Other
Clear selection
Mentor gender:
Strongly prefer female
1
2
3
4
5
Strongly prefer male
Clear selection
Mentor personality:
Strongly prefer hip
1
2
3
4
5
Strongly prefer nerdy
Clear selection
Any other preferences or comments?
Your answer
How did you hear about this program?
Your answer
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