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Code with Confidence – Application
Grade 6 & 7 students eligible
For the 2021-2022 school year
Date of Birth*
Telephone*Primary Parent Contact InformationPrimary Parent Name*
Relationship*(ie. Mother, Father) Address (If different from above)
Primary Contact Work PhonePrimary Contact Home PhonePrimary Contact Cell PhonePrimary Contact Email*
Other Contact InformationOther Contact Name
Relationship(ie. Mother, Father) Other Contact Address (if different from above)
Other Contact Work PhoneOther Contact Home PhoneOther Contact Cell PhoneOther Contact Email
Additional InformationStudent's Current School* School attending this upcoming school year* Grade entering this upcoming September* Please tell us why you would be a good candidate for this program. You can use any of the following ideas to answer this section: Why we should select you? Tell us about what you have done in this area up until now? Share with us ways that you don’t give up when things are challenging, how you work well with others, or how you demonstrate that you are respectful and responsible. This section is to be completed by the student as the purpose is to help us get to know you.*If possible, please provide samples or descriptions of coding projects you have completed.