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THANK YOU FOR TAKING THE NEXT STEP AND APPLYING FOR INDY WOMEN IN TECH MEMBERSHIP. INDY WOMEN IN TECH HAS PARTNERED WITH MULTIPLE ORGANIZATIONS TO HELP YOU OBTAIN THE NECESSARY TRAINING, EDUCATION, AND MENTORING TO PURSUE A CAREER IN TECH. WE UNDERSTAND THAT YOU MAY HAVE CHILDREN AND/OR TRANSPORTATION NEEDS, AND WE WILL PROVIDE THE NECESSARY FINANCIAL SUPPORT FOR CHILDCARE AND TRANSPORTATION COSTS, IF APPLICABLE. PLEASE FILL OUT THE BELOW FORM TO APPLY TO BECOME AN INDY WOMEN IN TECH MEMBER.


What is your Indiana county of residence?

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Will you require any of these services while participating in our educational programs? Select as many as apply:

List any other required services for participation:

Are there any classroom accommodations needed? If so, please provide:

Do you have any disabilities?:

What is your income level?:

What Is Your Ethnicity?:

If your ethnicity is not included above, please provide additional information:

What is your highest level of education?

If your highest level of education is not included above, please provide additional information:

Are you currently enrolled in an educational institution?

If so, what is the name of institution?

What is your field of study?

What is your expected graduation date?

Briefly describe your technical skill level and list any programs, applications or software that you use:

Current employment status:

If your current employment status is not listed above, please provide additional information:

What is the name your previous or most recent employer?

What was your most recent position or title?

What were the dates of employment?

Please describe what you have been doing for the last five years:

Are you or were you in the US Armed Forces?

What courses are you interested in? Select as many as apply:

Please include a short personal statement about yourself and your desired career goals:

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