Technovation for Good Application - Student Application

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Technovation for Good Application
Student Application

Student Information

First name:

Middle name:

Last name:

Chosen name:

Email address:

Please provide a non-student email address as we are unable to email student emails.

Identify as:

Ethnicity/race:

Address:

City:

State:

Zip:

County of Residence:

Home Phone:

Student's Cell Phone:

Parent Information

Parent 1 Information

Name:

Phone number:

Email address:

Parent 2 Information

Name:

Phone number:

Email address:

Additional Student Information

How did you learn about Technovation For Good?

Guidance Counselor

Teacher

Direct mail

Appalachian student or alumnus/alumna

Appalachian faculty or staff

Other

High School:

Expected Graduation Year:

Do you have any access requirements you would like us to be aware of?

List school clubs and activities in which you have participated. Please include length of involvement, positions held:

List any activities or organizations in which you participate outside of school:

Describe any voluntary or paid positions you hold or have held. Please include details on your time spent each week:

List any hobbies or special interests you have:

Describe the most challenging situation you have ever faced:

Tell us about your greatest accomplishment:

What do you hope to gain and learn the most from participating in Technovation For Good?

Describe how you have become interested in Technology or Entrepreneurship:

What or who motivated you to submit your application for the program?

References

Reference 1 Information

Name:

Phone number:

Email address:

Reference 2 Information

Name:

Phone number:

Email address:

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Technovation for Good Application - Student Application

Technovation for Good Application Student Application

Student Information

Parent Information

Parent 1 Information

Parent 2 Information

Additional Student Information

References

Reference 1 Information

Reference 2 Information

Technovation for Good Application
Student Application