Technovation for Good Application Form - Student Application

First Name *

Last Name *

Preferred Name *

Middle Name *

Student Email *

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

Identify As *

Female

Male

Non-Identifying

Ethnicity/race *

Street Address *

City *

State *

County of Residence *

Zip Code *

Home Phone *

Student's Cell Phone *

Do not list parent cell number.

Parent 1 Name *

Parent 1 Contact Number *

Parent 1 email address *

Parent 2 Name *

Parent 2 Contact Number *

Parent 2 email address *

How did you learn about Technovation For Good? 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:

List any college majors you are considering:

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?

Reference 1 Name *

Reference 1 Phone *

Reference 1 Email *

Reference 2 Name *

Reference 2 Phone *

Reference 2 Email *

Leave this field blank

Innovate for Good