Date of Birth
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Please provide your current full home address. (This is required for your application to be considered)
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City
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State
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Zip Code
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How many people are currently living in your household (including yourself)?
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Estimated Annual Household Income
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$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
What is your major? (If not enrolled, write n/a)
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Have you ever attended a community college: If other, please specify
What year do you expect to graduate? (If not enrolled, type n/a)
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If yes — please list the programs or placements you received through LA-Tech.org:
If you heard about LA-Tech.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?
Questions or notes about program commitment:
Short Answer #1) What interests you about this selected pathway and the LA Tech Rising Internship Program? How do you hope this experience will support your career goals?
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Short Answer #2) Describe a time you worked on a team. What was a challenge you faced, how did you communicate with others, and what did you learn about collaboration?
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Short Answer #3) This program requires consistent participation in live sessions and professional development activities. How do you stay organized and show up for your commitments?
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