#include 2017-2018 Registration
This form is for high school participants and should take between 10 and 15 minutes.
We distribute important program information after you submit this form, so please remember to fill this out as soon as you can.

Currently in the tech industry or in college and interested in mentoring? Please visit http://tinyurl.com/includeadvisor.
start
 
What is your first name? *

 
Hey {{answer_pHdxaRxBEYiI}}, nice to meet you.

What is your last name? *

 
What is your mailing address?

We plan on sending a care package sometime in November! :)
 
What is your street address? *

e.g. 111 Main Street, P.O. Box 40
 
What is your city? *

e.g. San Francisco
 
What is your zip code? *

 
What gender do you identify with?


 
What racial category or categories do you identify with?


 
What high school do you attend? *

Applicants to the #include Summit must be currently enrolled in high school, or home-schooled at the high school level, with the intention of receiving a high school diploma or completing the GED within the next four years.
 
Please provide the name of a counselor, principal, or teacher at your school.

 
What is your teacher/principal/counselor's name?

 
What is your teacher/principal/counselor's email?

 
What grade are you in? *


 
How did you find out about the #include Fellowship Program? *

If Facebook, please be specific (e.g. friend shared post; from __ group/page).
 
How many years of experience do you have with computer science? *

This is purely to see where our #include participants start. It won't be used for evaluation purposes.
 
What has your experience with computer science involved? *

e.g. self-studied, took AP computer science, made a website for a club, programmer for Robotics, etc.
This is purely to see where our #include participants start. It won't be used for evaluation purposes. Please be brief.
 
Do you want a #include Advisor?

This question is optional -- if you'd like us to match you with a college student or recent college graduate to help you with your initiative, please answer the following question:

Write a note to your future advisor telling him or her about you and what you're looking for in an advisor/advisee relationship. Suggested word length: 150 to 250 words
 
Please share with us anything else you would like us to know.

 
The next set of questions are aimed at figuring out how our #include initiative leaders view computer science. Please answer honestly - they have no effect on your application!

 
How likely are you to take a computer science class in the future? *

5 starts = very likely; 1 star = not likely at all





 
Knowing computer science/coding will be useful when I grow older. *

 
Computer science/coding is hard to learn. *

 
Computer science/coding is typically a boys' field. *

 
It's possible to easily incorporate computer science or technology into other industries, like art or music. *

 
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Thank you! Your application has been received.
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