Form

AZ Cyber Initiative

Summer 2024 Cyber Bootcamp Interest Form

First Name*

Last Name*

Street address*

City*

State/Region*

Zip code*

Arizona State County*

Email*

Secondary Email*

Mobile phone number*

Current High School Attending*

Anticipated Graduation Date*

Age*

Gender*

Race/Ethnicity*

Parent/Guardian First Name*

Parent/Guardian Last Name*

Relationship to Student*

Parent/Guardian Phone Number*

Parent/Guardian Email*

Other Parent/Guardian First Name*

Other Parent/Guardian Last Name*

Other Parent/Guardian Relationship to Student*

Other Parent/Guardian Phone Number*

Other Parent/Guardian Email*

Native Language*

Please select the 2024 Summer Bootcamp you would like to attend based on your Location and dates you're available:

ONLY Select a bootcamp for YOUR location. DO NOT select a bootcamp for each location or you will automatically be removed from every bootcamp applied for.

If you do not select a bootcamp at all you will not be added to a waitlist or contacted.

Phoenix Summer 2024 Bootcamp

Wilcox 2024 Summer Bootcamp

In submitting this interest form, I certify the following:*

I have read and understand the background information on the cyber bootcamps link below including the schedule attendance policy and cancellation fees

I am, to the best of my knowledge, available to attend Cyber Bootcamp sessions I selected as my preferred options.

I understand that, while there is no charge for participation in a Cyber Bootcamp, I will owe a $250 cancellation fee if I am offered and confirm a slot at one of the sessions and subsequently cancel or withdraw less than 1 week (7 days) prior to the first day of classes.

AZ Cyber InitiativeSummer 2024 Cyber Bootcamp Interest Form

Please select the 2024 Summer Bootcamp you would like to attend based on your Location and dates you're available:

AZ Cyber Initiative

Summer 2024 Cyber Bootcamp Interest Form