Disrupt Harlem Code Squad Interest Application
Welcome to the interest application for the Code Squad. Please fill this out by August 14, 2017.

Program Dates:
September 5th - December 14th : Coding & Entrepreneurship Training (MTW 10am-3pm)

If you have any questions please call 212-665-7010 or email harlembusinessalliance@gmail.com.

We'll reach out to you on AUGUST 16TH with next steps!

First Name *
Your answer
Last Name *
Your answer
Email *
Your answer
Cell Phone Number *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Current Address *
Your answer
Current Zip Code *
Your answer
Are you currently enrolled in school? *
If you answered yes, which school?
Your answer
What is your highest level of education? *
Have you completed any of the following workforce training programs? *
Required
Do you have any experience with building web or mobile applications or sites?
If yes, please tell us how long, skill sets: languages/frameworks, and describe project(s)
Your answer
What types of skills are you interested in exploring?
Everything will NOT be covered in this program. Just the subjects with the '*'. Check off as many as you like.
At the end of the program, will you be interested in any of the following: *
Please check all that apply.
Required
Will you be available to attend the program from September 5th - December 14th on weekdays from 10am-4pm? *
If you answered no, please tell us your schedule conflict:
Your answer
What's your favorite website or mobile app? Why?
Your answer
How did you hear about this program? *
Required
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