Student Info
Student's Full Name
Student's Email
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Student's Phone
Date of birth
School Name
Current Grade
K
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Parent/Guardian Info
Parent/Guardian's Full Name
Parent/Guardian's Phone
Parent/Guardian's Email Address
Program Interest
Which program(s) are you interested in?
Alpha Academy (Grades 6–10)
Alpha Beautillion (High School Seniors)
PHARAOHS (High School Juniors)
Summer Coding Academy (Rising 6th–8th grade students)
Troop 1906 / Pack 1906 (Elementary–Middle School)
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Communication Consent
May we contact you with program updates via email or text?
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Additional Notes (optional)
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