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DC3C Student Application (SY 2021-2022)
Thank you for your interest in applying for the upcoming 2021-2022 DC3C activities. Fill out the form and we can help to make sure you have the correct paperwork in.

DC3C is thrilled to offer new programming options this year. Some of these amazing activities are paid experiences and some are for community service hours.

Students must be between the ages of 14 and 21 years old, enrolled at a DC Public Charter school during the 2021/2022 school year (unless you are applying for Next Steps Career Exploration Conference - which is open to students from ALL DC high schools), and have a documented disability (IEP or 504)

Sign up below and we will work with eligible students to determine eligibility and obtain paperwork.  

If you're interested in participating in a WINTER/SPRING 2022 paid experience, start gathering the documents below.
1. A photo ID (If you're over 18, you must have a government issued photo ID)
2. A bank account for direct deposit
3. Birth certificate or Social Security Card (For I9 documentation)

For all questions or assistance with completing any forms, please contact exploredc3c@specialedcoop.org

Welcome to the DC3C family!


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First Name *
Last Name *
Student's Personal Email Address *
Date of Birth *
MM
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DD
/
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Student's Street Mailing Address *
Student's Apartment/Unit number (If applicable)
City *
State *
Zip Code *
Student's Grade for 2021/2022 School Year *
Student's Phone Number *
What is your gender identity? (Select all that apply) *
Required
Please share your pronouns. Pronouns are the part of speech used to refer to someone in the third person. We want to know how to respectfully refer to you! *
Required
What is your racial and/or ethnic identity? *
Do you have an IEP or 504 Plan? *
What is your disability? (Select all that apply) *
Required
Will you need accommodations in order to participate in our activities? If so, please explain.
Are you connected with RSA? *
Have you previously participated in DC3C programming? *
What DC3C activity are you interested in? (Check all that apply) *
Required
Your School's Name *
Your Case Manager's Name/School Contact *
Your Case Manager's/School Contact Email Address *
Your Parent/Guardian's First Name *
Your Parent/Guardian's Last Name *
Your Parent/Guardian's Email Address *
Your Parent/Guardian's Phone Number *
What language is spoken in your home? (Check all that apply) *
Required
What are your career interest(s)? (Check all that apply) *
Required
What is your dream job(s)/career? *
What are your strengths in school/work environment? *
What are your challenges in school/work environment? *
Is there anything else you would like for us to know about you?
How did you find out about DC3C programming? (Check all that apply) *
Required
Review the picture below that outlines the terms of service *
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