ExperienceIT Student Application Form
Email address *
Personal Information
Name *
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Nickname, if applicable
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Address *
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City *
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Phone Number *
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Email *
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Birthdate (optional)
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Gender *
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Race *
Are you a Veteran? *
Emergency Contact Name
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Relationship to Emergency Contact
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Emergency Contact Phone Number
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Academic Information
School/Organization *
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Highest Degree Obtained *
Major/Minor
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Skillset/Focus Area
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Expected Date of Graduation or Graduation Date
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GPA
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Desired Career Path *
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Employment Information
Current Employer (Or List Unemployed) *
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Current Job Title (Or List N/A, if unemployed) *
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Availability to Start *
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Willing to accept job, if offered? *
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Current Compensation *
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Desired Compensation *
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Desired Job Role *
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Other
What is your favorite modern day technology (device, app, program, etc.)?
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What development technologies do you have experience with? How would you rate yourself 1-10 in these technologies? What technologies are you interested in? *
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What technologies are you interested in? *
Your answer
How did you hear about ExperienceIT? *
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