NextBillion.org Mentorship: Student Application (Fall 2018)
Hey there! 👋Please take 10-15 minutes to fill out this form (resume required to complete application) and you'll hear from us by email within 1 day. We trust your story — we do not require any medical documentation for disability.

Learn more: www.nextbillion.org

Email address *
About NextBillion.org:
The goal of the Fall 2018 program is to support students with disabilities (physical, mental health, chronic, etc.) who are interested in working at tech companies (engineering, data, design, marketing, product or business roles). Invited students will receive free 1-on-1 career guidance, get matched with a personal mentor in their industry, and get access to a community + resources to land their next dream job or internship in tech. The program is supported by Queen Elizabeth II, Westly Foundation, Roddenberry Foundation & some Fortune 500 companies.
Free mentorship for any student with disability in tech in US & Canada. Now accepting applications for Fall 2018.
First Name *
Last Name *
Gender *
University Details
University Name *
Which program are you enrolled in (or graduated from)? *
Program Major *
Graduation Year (or expected graduation year) *
University Email Address *
Must be an '.edu', '.ca', or other official university email
Location
We are legally required to record this information in order to refer students from our community to employers.
Address *
City, State *
Disability
Do you identify as a person with disability?
We follow the legal definition of 'disability' as defined by the Americans with Disabilities Act (ADA): www.ada.gov/cguide.htm. If you're not a person with a disability, you can still sign up for the NextBillion.org newsletter at www.nextbillion.org.
What type of disability do you have?
Your response is 100% confidential and will not be shared with anyone without your permission. The type of disability does not affect your application. If you choose to skip this step, your application may not be considered since we're currently focusing on supporting people with disabilities.
What specific disability do you have?
Your response is 100% confidential and will not be shared with anyone without your permission. If you choose to skip this step, your application may not be considered since we're currently focusing on supporting people with disabilities.
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