Illinois Computes High School Contact Submission

1. Please begin with some information about your self:

Except for your name, this information is optional, but it helps us to make connections and forge links to diverse groups of students.

Name:         Born: Year:

Ethnic Background:          

Fill in any of the following ways we can contact you:

Work Phone: ( ) - x   Home Phone: ( ) -

Cell Phone: ( ) -   E-mail address:

2. Now please provide information about your contacts at a single high school. (Please revisit this form for other high schools.)

Please select the high school from the following menu covering most schools in Cook, DuPage, Lake, and Will Counties in Illinois: For a school not listed, please email

I am an alum of this high school:    

I am interested in visiting this high school along with an Illinois Computes representative.    

Provide information here on the most relevant contacts, e.g., teachers, career counselors, administrators, etc. Be as specific as possible about position, e.g., "math teacher", "science chair", "assistant principal", etc.

  1. Name:   Position:
    Phone:( ) - x   Email:
  2. Name:   Position:
    Phone:( ) - x   Email:
  3. Name:   Position:
    Phone:( ) - x   Email:
  4. Name:   Position:
    Phone:( ) - x   Email:
  5. Name:   Position:
    Phone:( ) - x   Email:


3. Thank you. Your assistance is greatly appreciated. Be sure to press the button below when you are done!