Registration – Little Geniuss

Registeration Form

Registration Form

Name *

First

Last

Student's Phone Number

Student's Email

Country

State

Address

Age

Gender

Do you have a laptop?

Name of School

School Address

Class or Grade

Type of School You Attend

How did you hear about our STEM Camp

This STEM Bootcamp Fee costs USD $700 Only. If you are accepted, you will be required to make payment prior to the start date. Payment information will be provided to you once we confirm your admission.

Name of Parent/Guardian

Relationship with student (Father, Mother, Uncle, Aunt, Guardian, Sponsor etc)

Guardian email

Guardian Phone number

Do you give consent to your daughter/ward to participate in our Code School?

Today's Date

Registeration Form

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