Date of Birth
*
Street Address. Note: If you are living in on-campus housing, please include your dorm address, not your school’s general address. [Please type in your full address, ex: 1245 Street Name, Los Angeles]
*
City - Note: At this time, only applicants who reside in LA County will be considered. This requirement is set by our LA County partners, not by LA-Tech.org.
*
State
*
Zip Code
*
Current Age
*
Opportunity Youth: The following questions will be used to determine whether you qualify for additional programs/funding through LA-Tech.org and our partner organizations. LA-Tech.org provides additional supportive programming to low- income, homeless, foster and formerly incarcerated youth to provide them with access to paid internships and jobs with our partner companies. All answers to these questions are confidential and are solely used for internal processes.
How many people are currently living in your household (including yourself)?
*
[NEW] Estimated Household Income
*
$10,000 to $19,999
$100,000 to $149,999
$150,000 or more
$20,000 to $29,999
$30,000 to $39,999
$40,000 to $49,999
$50,000 to $59,999
$60,000 to $69,999
$70,000 to $79,999
$80,000 to $89,999
$90,000 to $99,999
Less than $10,000
If you pay rent, please indicate the amount you pay monthly. If this does not apply to you, type N/A.
*
Please share with us what roadblocks you have experienced
*
If yes, what is the name of the college or university you are currently attending?
If "Other College", please type if the name of the college or university you are currently attending.
*
What is your major? [If not enrolled, please type in "Not Currently Enrolled"]
*
Have you ever attended a community college: If other, please specify
What year do you currently expect to graduate college? Please only input the year. [If not enrolled please type in "Not Currently Enrolled"]
*
Please list the academies or internship placements that you’ve received through LA-Tech.org
If you heard about LATech.org through a friend, please type their first and last name:
If you heard about LATech.org through a staff member, please type their first and last name:
If other, how did you hear about us?
If you selected any of the options from above, please list them here:
What inspired you to apply for the LA Tech Rising Internship Program (IT/Cybersecurity & Software Engineering), and how does it align with your career goals? Explain how you believe the internship would contribute to your professional development and help you achieve your career aspirations.
*