Summer Workshop Enrollment Form

Are you under the age of 18?

You will need your parent or guardian's approval before submitting your application. Please have your parent or guardian read through the materials enclosed above before continuing with this application.

They will also need to be present with you at the agreement page at the end of this application form to give their approval.

Are you under the age of 18? *

Contact Information

First Name*

Last Name*

What other name do you go by (if any)?

Email Address*

Phone Number*

Date of Birth*

City*

State*

Zipcode*

Home Address*

Name of Parent/Guardian*

Parent/Guardian Phone Number*

Parent/Guardian E-mail Address*

Address of Parent/Guardian*

Demographics

What is your level of education?*

Race*

Hispanic Origin*

Gender*

Disability*

Are you a Veteran?*

CFA/DSYA Programs

Do you have any learning disabilities or need any special accommodations that we should be aware of to support your learning experience?

College Information

Accepted students will need to fill out the release forms below to be formally accepted into the program.

High School Information

Are in high school? What high school or GED program did you graduate from?

Work / Volunteer Experience

Work / Volunteer Experience #1

Employer Name

Position

Dates of Employment (Month/Year)

Contact Info (Supervisor, Address, Phone)

Work / Volunteer Experience #2

Employer Name

Position

Dates of Employment (Month/Year)

Contact Info (Supervisor, Address, Phone)

Work / Volunteer Experience #3

Employer Name

Position

Dates of Employment (Month/Year)

Contact Info (Supervisor, Address, Phone)

Job Title

Job Location

Job Schedule

Career Goals

Do you attend or do you plan to attend college or a trade school? *

If yes, where do you plan to apply?

What career(s) are you interested in at this time?

What do you like to do in your spare time?

How do you think this program will assist you in reaching your future career goals?

What kinds of things are you good at? (Art, basketball, music, etc.)

Technology

Please rate your current abilities in the following categories.

This information is not used to determine your eligibility as part of the program, but helps us ascertain what skills you have yet to learn.

Please answer these questions honestly.

Specific Technology Skills

Please rate your current abilities in the following categories.

This information is not used to determine your eligibility as part of the program, but helps us create curriculum and measure performance over the course of the internship program.

Please answer these questions honestly.

Short Answer Questions

Please answer each of the questions below in at least one (1) paragraph and within 200 words or less.

What are your future goals? *

What do you hope to get out of this program? *

What do you plan to do with the stipend you earn (applies to young adults 16 - 24 only)? *

Other Information

Where did you hear about the CFA/DSYA program? *

Have you participated in a pre-apprenticeship or tech training program before? *

If yes, what was the name of the program(s)?

Are you able to use ZOOM for online classes? *

Do you have a camera on your computer and are you willing to keep your camera on during class? *

Program Consent

If you are under the age of 18, you will need your parent or guardian's approval before submitting your application. Your parent or guardian must be present with you when filling out the agreement on the next page and will need to enter their name and date to confirm they have read and understand the materials enclosed in this application form.

Are you under 18 years of age? *

Computing for All Student Code of Conduct

While attending CFA during regular hours or during CFA-sponsored activities, students are expected to follow these basic rules, procedures, and expectations:

Join the Zoom class with a laptop or desktop, camera, and microphone, ready to work at the designated time that class begins. If you do not have a working laptop, camera, or microphone or need a hotspot for internet connection, please let us know before classes start and we can try to help you get set up.
Attendance and participation in class are an essential part of the work training process. If you know you are going to be late or absent, please text, email, or call both the administrator and your teacher.
Your priority at is to learn. Avoid distractions that interfere with or are counter-intuitive to that mission.
Always use work-appropriate language while maintaining friendly and courteous behavior.
Be polite and respectful to everyone, including your peers, teachers, administrators, support staff, and visitors.
Follow individual teacher instructions, rules, and expectations at all times.
Do not become a distraction for others. Help to create a safe space where every student has the opportunity to maximize their potential. Critiques of student work should be constructive, encouraging, positive, and helpful.
All students are free to express their own points of view and are protected from those who would inhibit that expression. However, freedom of speech is a right that carries with it certain responsibilities and its exercise is subject to limitations as to time, manner, and place. Computing for All reserves the right to restrict or limit speech that causes discomfort to students, teachers, or guests or disruption to class.
Represent yourself in a manner that you will be proud of in years to come. Take advantage of the opportunities you have at here. They will help you be successful throughout your life.

Media and Photo Release Form

For whom are you filling out this release form?*

Students Under 18 Release Form

Applicant Media and Photo Release Form

I, [PARENT / GUARDIAN], hereby grant permission to the Computing for All (CFA) Digital Skills Youth Academy (DSYA) Program employees and agents and assigns the right to record and/or use my [CHILD]’s likeness, image, name, voice and/or statement(s) and/or work(s), as recorded by any means and in any medium (including but not limited to our website and social media) existing now or developed in the future. CFA DSYA may utilize any and all photos, audio or video recordings created directly or indirectly in connection with the CFA DSYA program without further approval by or payment to me. I also grant permission to use, edit and/or modify the photos, recordings, in any manner, form or medium, for or in connection with the program and the charitable purpose of the program. I hereby waive any and all rights that I may have to inspect or approve the photos, recordings, or the use to which they may be applied, as long as they are used in the publicizing, showcasing, marketing and/or promotion of the CFA Digital Skills Youth Academy Program.

By entering your full name under the PARENT / GUARDIAN field below, your child's full name under the CHILD field below, and entering today's DATE, you are agreeing to the terms and conditions detailed above.

PARENT / GUARDIAN *

Child *

Date Signed *

I, [APPLICANT], hereby grant permission to the Computing for All (CFA) Digital Skills Youth Academy (DSYA) Program employees and agents and assigns the right to record and/or use my likeness, image, name, voice and/or statement(s) and/or work(s), as recorded by any means and in any medium (including but not limited to our website and social media) existing now or developed in the future. CFA DSYA may utilize any and all photos, audio or video recordings created directly or indirectly in connection with the CFA DSYA program without further approval by or payment to me. I also grant permission to use, edit and/or modify the photos, recordings, in any manner, form or medium, for or in connection with the program and the charitable purpose of the program. I hereby waive any and all rights that I may have to inspect or approve the photos, recordings, or the use to which they may be applied, as long as they are used in the publicizing, showcasing, marketing and/or promotion of the CFA Digital Skills Youth Academy Program.

By entering your full name under the APPLICANT field below and entering today's DATE, you are agreeing to the terms and conditions detailed above.

By entering your name below you are stating that you have read all enclosed materials concerning the DSYA Program and that all statements you have made in the application are true to the best of your knowledge. If accepted, you will be committed to attending classes and meeting all program requirements.

Applicant *

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