Tech Crew - Youth Ambassador Application

Question Title

1. Contact Information (Required.)

Name

ZIP/Postal Code

Email Address

Phone Number

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2. Date of Birth (Required.)

Date / Time

Date

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3. If under 18, has your parent or guardian given you permission to participate? (Required.)

Yes

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4. Please provide your parent/guardian's contact information (Required.)

Name

ZIP/Postal Code

Email Address

Phone Number

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5. Please indicate which site(s) you may have affiliations with:

Flint Development Center

Hasselbring Senior Center

Latinx Technology and Community Center

Ministry and Community Center

R.L. Jones Community Outreach Center

Other (please specify)

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6. Possible Day of the Week Preferred: (Required.)

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

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7. Please provide your current school/work schedule (Required.)

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8. Please provide your Summer school/work schedule (Required.)

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9. If you are selected for the program, we will pay you a stipend for your work and volunteer activities. Please provide your cashApp name. (Required.)

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10. Are you an Android or Apple user? (Required.)

Android

Apple

Both

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11. How would you rank your smartphone feature expertise? (Required.)

	Genius	Expert	Above Average	Average	Novice
Android	Android Genius	Android Expert	Android Above Average	Android Average	Android Novice
Apple	Apple Genius	Apple Expert	Apple Above Average	Apple Average	Apple Novice
Other (General Computer Software/platforms)	Other (General Computer Software/platforms) Genius	Other (General Computer Software/platforms) Expert	Other (General Computer Software/platforms) Above Average	Other (General Computer Software/platforms) Average	Other (General Computer Software/platforms) Novice

Tech Crew - Youth Ambassador Application

Question Title

* 1. Contact Information (Required.)

Question Title

* 2. Date of Birth (Required.)

Question Title

* 3. If under 18, has your parent or guardian given you permission to participate? (Required.)

Question Title

* 4. Please provide your parent/guardian's contact information (Required.)

Question Title

* 5. Please indicate which site(s) you may have affiliations with:

Question Title

* 6. Possible Day of the Week Preferred: (Required.)

Question Title

* 7. Please provide your current school/work schedule (Required.)

Question Title

* 8. Please provide your Summer school/work schedule (Required.)

Question Title

* 9. If you are selected for the program, we will pay you a stipend for your work and volunteer activities. Please provide your cashApp name. (Required.)

Question Title

* 10. Are you an Android or Apple user? (Required.)

Question Title

* 11. How would you rank your smartphone feature expertise? (Required.)

1. Contact Information (Required.)

2. Date of Birth (Required.)

3. If under 18, has your parent or guardian given you permission to participate? (Required.)

4. Please provide your parent/guardian's contact information (Required.)

5. Please indicate which site(s) you may have affiliations with:

6. Possible Day of the Week Preferred: (Required.)

7. Please provide your current school/work schedule (Required.)

8. Please provide your Summer school/work schedule (Required.)

9. If you are selected for the program, we will pay you a stipend for your work and volunteer activities. Please provide your cashApp name. (Required.)

10. Are you an Android or Apple user? (Required.)

11. How would you rank your smartphone feature expertise? (Required.)