General Information

Thank you for your interest in the GenCyber Space Challenge Program being conducted in August 2022 at Cape Cod Community College!  The GenCyber Space Challenge Program is funded via a grant from the GenCyber Program housed at the National Security Agency.  

In order to provide a quality experience, space in each of the summer sessions is limited. Please complete the entire application form.  If you have any questions, please contact the GenCyber Space Challenge Program at GenCyber@capecod.edu or (774) 330-4459. 
 
Paper applications are available upon request at GenCyber@capecod.edu. 

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* 1. Please select the week the student would like to attend the program or indicate if there is no preference.  Students may attend only ONE week.

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* 2. If there are more applicants than spaces available, CCCC will start a waiting list in case spaces open up before the start of the program. Would you like your name put on a waiting list if necessary?

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* 3. Has your family attended one of the space challenge events held at CCCC for families interested in learning more about the summer week-long GenCyber Space Challenge program?

(Note: Final event is being held April 30, 2022 at CCCC)

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* 4. Please provide the following contact information.

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* 5. Please provide the following information about the student's school.

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* 6. Student's Date of Birth.

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* 7. Student Gender

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* 8. In the fall of 2022, this student will be entering grade:

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* 9. Is the participating student eligible for free or reduced-price meals from their school?

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* 10. Please indicate the race of the student participant. (Select all that apply)

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* 11. Please indicate the ethnicity of the student participant.

For grant reporting, Hispanic or Latino ethnicity is defined as a person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin regardless of race.

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* 12. Please select the highest level of schooling either parent/guardian in the household has completed.

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* 13. Please briefly describe the student's interest in learning more about cyber security?

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* 14. Primary Emergency Contact Information

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* 15. Secondary Emergency Contact Information

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