Cisco & UCCI: 2021 STEM Summit Registration

We are so excited for our upcoming WomenRock-IT STEM Summit hosted by Cisco Systems in partnership with University College of the Cayman Islands! The Summit will take place on August 2 and 3 for young women ages 13-18 on UCCI's campus on Grand Cayman. Space is limited to the first 35 registrants, who will have access to a jam-packed agenda filled with guest speakers, coding activities, and mentoring sessions to help you learn the top skills sought after by companies in the STEM industry! Completing this form lets us know that you would like to attend. If you are one of the first 35 to sign-up, you will receive an email with more information. Note: this form has a parent/guardian approval box. Please fill this form out with a parent/guardian present. We can't wait to see YOU on August 2 for our Summit!

Student First and Last Name*

Student Email Address*

Student T-Shirt Size*

Select

Student Age*

What high school/university do you attend?*

What interest do you currently have in pursuing education/jobs in STEM (Science, Technology, Engineering, Math)?*

To be answered by the student.

What specifically about STEM careers would you like to learn more about during this summit?*

To be answered by the student.

Special Dietary Restrictions or Medical Issues:*

Do you reside on Little Cayman or Cayman Brac?*

Select

If you answered yes:

Would you like to apply for a travel scholarship for you and a parent/guardian to help with the cost of travel to Grand Cayman?

Select or enter value

Parent/guardian First and Last Name*

If child is under 18, to be completed by the parent/guardian.

Parent/guardian Phone Number*

Parent/guardian Email*

Guardian Approval*

By Submitting this application, I agree (or parent giving consent, if child is under 18) to: 1) Attend all sessions as scheduled except in the case of illness or emergency. 2) Participate in all activities to the best of my ability. 3) Show respect for myself, the facilitators, fellow participants, and campus property. 4) Abide by the rules regarding behavior and safe/appropriate use of equipment and tools. 5) Be photographed and videotaped whilst participating in the summit and provide consent for UCCI and Cisco to use such recordings for public viewing. 6) Release Cisco and UCCI of all liability related to exposure of Covid-19.

Send me a copy of my responses

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