Campus Philly Tech Scholars
Scholarship Application

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Contact Information

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country

Email Address *

Phone Number *

Question Title

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

African American

Asian American

Asian/Indian Subcontinent

Hispanic/Latino

Mexican American/Chicano

Native American

Native Hawaiian/Pacific Islander

Puerto Rican

White/Caucasian

Multiple ethnicity / Other (please specify)

Question Title

* 5. Name of the 2 or 4 year college/university you are currently enrolled in

Question Title

* 6. Anticipated Graduation Year

Question Title

* 7. What is your major?

Question Title

* 8. Location of High School you graduated from (only enter city/country if you are an international student)

City/Town *

State/Province

Country *

Question Title

* 9. Hometown zipcode (enter 00000 if you are an international student)

Question Title

* 10. Internship Status

Participated in summer 2021 internship or co-op

Currently (as of October 1, 2021) in a fall internship or co-op

Question Title

* 11. Was your internship paid? (Choose one)

Paid

Unpaid

Underpaid (<$15/hr)

Question Title

* 12. Duration of internship

Start Date

End Date

Total number of hours

Question Title

* 13. Internship Job Title

Question Title

* 14. Share a summary of your internship responsibilities

Question Title

* 15. Name and Address of Internship Employer

Name of Supervisor *

Company *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address of Supervisor *

Phone Number of Supervisor *

Question Title

* 16. Employer Website

Question Title

* 17. Please share your future career aspirations in Tech (In 500 words or less)

Question Title

* 18. Outside of your classes and your internship, how have you been involved in the Philadelphia Tech community? (In 500 words or less)

Question Title

* 19. In what ways has Campus Philly helped you connect to an internship or job? (Please check all that apply)

I attended a virtual job fair hosted by Campus Philly

I attended a virtual career event with a recruiter or employer, hosted by Campus Philly

I learned about an interesting employer through Campus Philly

I receive Campus Philly emails with job and internship info

I follow Campus Philly on social media

Other (please specify)

None of the above

Question Title

* 20. Would you like to receive information about our partners in the Most Diverse Tech Hub initiative?

Coded by Kids - Tech and Innovation internships for college students

Venture for America - Fellowship opportunities for recent college grads

Technical.ly - Subscribe and stay on top of tech news daily

Campus Philly Tech ScholarsScholarship Application

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Contact Information

Question Title

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

Question Title

* 5. Name of the 2 or 4 year college/university you are currently enrolled in

Question Title

* 6. Anticipated Graduation Year

Question Title

* 7. What is your major?

Question Title

* 8. Location of High School you graduated from (only enter city/country if you are an international student)

Question Title

* 9. Hometown zipcode (enter 00000 if you are an international student)

Question Title

* 10. Internship Status

Question Title

* 11. Was your internship paid? (Choose one)

Question Title

* 12. Duration of internship

Question Title

* 13. Internship Job Title

Question Title

* 14. Share a summary of your internship responsibilities

Question Title

* 15. Name and Address of Internship Employer

Question Title

* 16. Employer Website

Question Title

* 17. Please share your future career aspirations in Tech (In 500 words or less)

Question Title

* 18. Outside of your classes and your internship, how have you been involved in the Philadelphia Tech community? (In 500 words or less)

Question Title

* 19. In what ways has Campus Philly helped you connect to an internship or job? (Please check all that apply)

Question Title

* 20. Would you like to receive information about our partners in the Most Diverse Tech Hub initiative?

Campus Philly Tech Scholars
Scholarship Application