Girls For Technology/GalaxE Solutions Service desk trainee program Application Form Spring 2022 Cohort 2

1. Personal Information

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

MM/DD/YYYY

Date

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Other (please specify)

Male

Female

Transgender

Prefer not to answer

Prefer to self-identify

Other (please specify)

Girls For Technology

Indeed

Social Media

School

CWP

Other Sources