Student Application

Step 1 of 6 – Contact Information

Comments

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Contact Information

This step begins your application process. Please complete the application contact information below then proceed to the next steps in our application process.

Name(Required)

First Last

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Email(Required)

Enter Email Confirm Email

Date of Birth(Required)

Month

Day

Year

Phone(Required)

How did you hear about us?(Required)

Name of the person who told you about us:

Registration Date

Training Name

Tell Us About Yourself

What is Your Gender?(Required)

What is your race and ethnicity?(Required)

How many people live in your household, include yourself?(Required)

Do you have a disability?(Required)

Do you have any of the following? (Select all that apply)(Required)

I have a bank account (checking or savings)

I have access to reliable transportation

I own a home

I prefer not to say / none of the above

We strive to host inclusive, accessible events that enable all individuals, including individuals with disabilities, to engage fully. Would you like to request any special accommodations or inquire about accessibility? If so, please detail below.

Employment Information

Are You Currently Employed?(Required)

Do you receive employee benefits? (Select all that apply)(Required)

Health or Life Insurance

Paid Time Off (PTO)

Professional Development Stipend

Tuition Reimbursement

Retirement Plan (Pension. 401(k), etc.)

No Benefits

I am not employed.

Your highest level of education completed?(Required)

What is your current annual (yearly) income?(Required)

Have you ever been convicted of a crime?(Required)

If yes, please explain here.

Your Technical Background and/or Interest

Do you have a background in tech?(Required)

If other, please explain here

Resume Attachment

Your resume can include all your recent work experience(s). This includes any current position(s) you have that are not tech related.

Upload Your Resume(Required)

Max. file size: 256 MB.

Identity Verification

We are required to verify your identification and confirm your identity as part of of our intake process.

Take a photo of your state issued ID

Max. file size: 256 MB.

Attendance Policy

This training program has a strict attendance requirement. You are only allowed one unexcused absence. Do you consent to adhere to our strict attendance policy?(Required)

Read the complete attendance policy here:

Yes

Also, during trainng we photograph and/ or record our training. Do you consent to being photographed and recorded as a part of your participation in our activities?(Required)

Yes

Please review and accept the terms and conditions.(Required)

I agree to the Terms and Conditions and understand that this application does not guarantee a spot in the upcoming training. Course materials will be provided upon enrollment.

Submit Your Application

Once submitted you will receive a confirmation email along with instructions for next steps.

Enrollment Process Timeline