NextBillion.org Mentorship Application: Spring 2019
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. We trust your story — we do not require any medical documentation for disability.

Learn more: www.nextbillion.org

Email address *
About our community:
Our goal is to build a supportive community of people with disabilities (physical, mental health, chronic, etc.) in tech (engineering, data, design, marketing, product or other roles). Invited candidates will receive access to a Slack community, curated resources to clarify questions about your job process and referrals to companies actively looking to hire people with disabilities. Our community is supported by leaders such as Queen Elizabeth II, Westly Foundation, Roddenberry Foundation & Fortune 500 companies.
Overview of Next Steps:
1) We'll verify your application and that you're eligible to join our community.
2) We'll email you (please keep an eye out for the next step) to schedule a 30-minute call to evaluate and better understand your challenges and needs.
3) You'll be invited to our online community and receive mentorship based on where you're at in the job process.
Get started:
First Name *
Last Name *
Phone Number *
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 *
Country *
Demographic Information
Gender *
We want to ensure that we're being inclusive in the community that we're building.
Race / Ethnicity *
We want to ensure that we're being inclusive in the community that we're building.
Required
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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