Coding4Cyber Summer Camp Scholarship Request
CyberSecurity GameChangers offers financial assistance through our scholarship program to prospective campers with financial need. Approval of the application is made on an individual basis.  Individuals who receive any type of government assistance are automatically eligible for a scholarship. Those that do not receive any type of assistance will be evaluated based on household income. Fill out the form below to apply for financial assistance for Coding4Cyber Summer Camp 2021. Applications will be accepted from May 1st thru June 23rd.  Recipients will be notified no later than June 25th. (1 application per each student attending.)

Please complete the information for each student that you wish to apply for a scholarship. (ie Student 1 - 4)

Sign in to Google to save your progress. Learn more
Email *
Parent First & Last Name *
Parent Email Address *
Parent Telephone Number *
Zip Code *
Student 1 First & Last Name *
Student 2 First & Last Name
Student 3 First & Last Name
Student 4 First & Last Name
Student 1 Age *
Student 2 Age
Student 3 Age
Student 4 Age
Student 1 Grade *
Student 2 Grade
Student 3 Grade
Student 4 Grade
Student 1 Gender *
Student 2 Gender
Clear selection
Student 3 Gender
Clear selection
Student 4 Gender
Clear selection
Race *
Household Income (Annual) *
Number of Adults in Household *
Number of Children in Household *
Household Receiving Government Assistance? *
If "Yes" to question above, specify type of assistance. Select all that apply to your situation.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of CyberSecurity GameChangers. Report Abuse
Google Forms