Learn2Earn Plus Application - 2019

Learn2Earn Plus Program Requirements and Qualifications

Thank you for your interest in our Learn2Earn Plus Program. In this program you will learn the basics of computer hardware, software, networking, coding, and designing through 25+ hours of hands-on instruction. Upon completion of the training, you will earn a refurbished laptop to keep for use at school, home, or in college.

Sessions will take place on after school (up to) two times per week. You will be required to attend 80% of sessions to qualify for the laptop. Once we have received your application we will follow up with your campus start date.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. What is your student ID number?

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* 4. What is your home address?

Address

City/Town

State/Province

ZIP/Postal Code

Phone Number

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* 5. What is your email address?

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* 6. What is your date of birth?

Date / Time

Date

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* 7. What is your grade level?

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* 8. What is your school's name?

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* 9. Which race/ethnicity best describes you? (Please choose only one.)

American Indian or Alaskan Native

Asian / Pacific Islander

Black or African American

Hispanic

White / Caucasian

Multiple ethnicity / Other (please specify)