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Eli Madison Memorial Apprenticeship            (EMMA) Intake Form
Please fill out this form to apply for the Eli Madison Memorial Apprenticeship in Mainframe zOS 
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Full Name (Include First/Given Name(s) and Last/Family/Surname) *
Email (Example: bobbyboy@snailmail.com)  
*
Phone Number (Include Area Code) *
City (Example: Brooklyn) *
State (Example: NY) *
Zip Code (Example:11221) *
Country Code (Example: USA) *
Are you Homeless? *
Are you a legal U.S. Citizen? *
Can you pass a background check *
Required
If not a U.S. citizen, do you have a green card or require sponsorship? *
If you hold a non-immigrant visa, please specify your visa type:  
*
Do you have a current visa that permits work in the U.S.?  
*
Do you need a visa sponsorship to participate in this apprenticeship?  
*
Please provide the expiration date of your current visa (if applicable): *
Are you a veteran *
How many years of Mainframe experience do you have?
What programming languages do you know?
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Have you undergone a background check within the last 12 months?  
*

Do you currently hold, or have you ever held a security clearance, including public trust positions?

*
Level of Clearance:
*
Issuing Agency and Date (if applicable) *

Consent to Terms and Conditions

By submitting this form, I confirm that all the information provided is accurate to the best of my knowledge. I acknowledge that submission of this form does not guarantee my acceptance into the Eli Madison Memorial Apprenticeship. Acceptance is contingent upon meeting the program's eligibility requirements and the decision of the program organizers. I also understand that submission of this form does not imply any offer of employment, sponsorship for U.S. work authorization, immigration status, or security clearance. Failure to meet program conditions or misrepresentation of information may result in disqualification.

Data Protection and Privacy Notice

I acknowledge that the information I have provided will be collected and processed in accordance with applicable data protection laws, including the [Your Country] Data Protection Act [or GDPR, if applicable]. This data will be used solely for the administration and execution of the apprenticeship program. Submission of this form does not authorize the use of my personal data for purposes of sponsorship, visa processing, or security clearance facilitation unless explicitly stated and agreed upon separately. My personal information will not be shared with third parties without my explicit consent unless required by law.

Non-Discrimination and Equal Opportunity

I understand that the Eli Madison Memorial Apprenticeship operates in full compliance with anti-discrimination laws and ensures equal opportunity regardless of race, color, religion, sex, national origin, age, disability, or any other protected status. Selection into the program will be based on merit and qualifications alone.

Program Modifications and Disclaimers

Submission Does Not Guarantee Acceptance
The submission of this form and the information provided does not constitute an offer or guarantee of acceptance into the Eli Madison Memorial Apprenticeship. All applications are subject to review, and acceptance is contingent on meeting the program's eligibility requirements and approval by program organizers.

No Implication of Sponsorship or Employment
Submission of this form does not imply or create any employment relationship, sponsorship for U.S. immigration status, visas (including, but not limited to, H1-B, F-1, or J-1 visas), or permanent residency (green card) status. The Eli Madison Memorial Apprenticeship does not provide sponsorship for international participants or facilitate immigration proceedings. Participants should independently ensure their legal right to work or participate in the program in their respective countries.

No Implication of Security Clearances
Submission of this form does not imply or guarantee any security clearances that may be required by national or international law. The program does not provide, sponsor, or facilitate the application process for security clearances that may be needed for certain positions or activities during the apprenticeship. Participants are solely responsible for obtaining any necessary clearances.

Program Modifications
The Eli Madison Memorial Apprenticeship Program reserves the right to alter, suspend, or terminate the program at any time without prior notice. Such changes may include adjustments to the program structure, requirements, or participation guidelines. The program organizers will not be held liable for any costs or damages resulting from these modifications, including any impact on participants' immigration or employment status.

International Participation
The Eli Madison Memorial Apprenticeship Program accepts applicants globally, subject to compliance with applicable international laws and restrictions. Applicants must comply with all relevant laws and regulations in their respective countries. The program does not guarantee that participation will fulfill any national or international legal requirements, such as those relating to apprenticeships, internships, or employment contracts. Participants are responsible for ensuring their own legal compliance.

Liability Disclaimer

By submitting this form, I acknowledge that participation in the apprenticeship program may involve certain risks, and I agree to release the Eli Madison Memorial Apprenticeship Program, its staff, and affiliates from any liability related to injuries, damages, or losses incurred during program activities, except where such liability is caused by negligence or willful misconduct on the part of the program organizers. Additionally, I understand that I am responsible for securing any necessary work authorizations, visas, or clearances, and the program will not be liable for any legal or financial consequences arising from immigration, visa, or sponsorship issues.

Governing Law and Jurisdiction

This agreement, and any disputes arising from its submission or participation in the  Eli Madison Memorial Apprenticeship Program, will be governed by and construed in accordance with the laws of the State of [Insert State], without regard to its conflict of laws principles. Any legal actions or claims arising from participation in the program must be brought in the appropriate courts of [Insert State]. The LLC adheres to all applicable federal and state laws, including but not limited to:

State LLC Laws: Governing formation, management, and dissolution of the LLC.Federal Tax Laws: Including requirements for tax filings and compliance.State and Local Tax Laws: Including sales, use, and income taxes.Employment Laws: Including labor laws, workplace safety, and employee benefits.Federal Regulations: Including data protection and non-profit compliance (if applicable).Contract and Commercial Laws: Governing business agreements and intellectual property.Privacy Laws: Including consumer privacy regulations.

Signature and Consent

By checking the box below and submitting this form, I confirm that I have read and understood the terms and conditions outlined above, and I agree to be bound by them. I also consent to the use of my information for the stated purposes and agree to abide by the program’s policies.

This version integrates the necessary legal disclaimers and details regarding the governing laws for the LLC, ensuring comprehensive coverage and clarity for all participants.


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