NITW Database Intake Form
Please complete the following form as completely and accurately as possible. Based on your answers regarding your education, experience, skills, and interests, you will be considered for employment opportunities with companies who are interested in supporting a neurodiverse workforce.

Please keep in mind that the timing and location of the programs that we work with are hard to predict, so we are not able to guarantee when an opportunity matching your qualifications will happen. When we are able to match you with a position, we will contact you by email and/or phone.

Feel free to reach out to the Neurodiversity In The Workplace team at Neurodiversity@nitw.org with any questions or updates if your information changes.
Last name, first name *
Your answer
What is your phone number (xxx-xxx-xxxx)? *
Your answer
What is your email address? *
Your answer
What city do you live in? *
Your answer
What state do you live in? *
At what college/university did you attain your highest degree? *
Your answer
What is/was your major? *
Your answer
What year did you or will you graduate? *
Your answer
What is the highest degree you have attained or are in the process of attaining? *
Required
Select 1-3 relevant fields of interest for you. *
Required
Please list some of your professional skills (for example: social media marketing, GIS visualization, Microsoft Excel, Photoshop, etc).
Your answer
Please check any areas of technical skill that you have studied.
What is your current employment status? *
Why are you interested in changing your current employment situation? *
If an opportunity was identified for you, would you be open to traveling for an interview and potentially relocating for a job? *
If you are open to relocating, please check which regions of the USA you would be open to working in.
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