#100Devs Application
Why are you interested in learning web development? *
First Name *
Last Name *
Email *
Date of Birth *
MM
/
DD
/
YYYY
Were you affected by COVID-19? *
If yes, please let me know how?
What is your Twitch Username? If you do not have one, please create an account and follow twitch.tv/learnwithleon *
What is your Discord Username? If you do not have one, please join leonnoel.com/discord *
About you
These questions are my way of understanding who I am serving in the classroom. None of this will ever be published or shared in a way that it can be tied back to you.
Gender *
With which race / ethnicity do you most identify? *
What's your highest level of education? *
How did you hear about the class? *
Do you require any accommodations in the classroom?
Clear selection
If yes, please let me know how I can best help you in classroom.
Anything else I should know about you?
Since this class will be conducted virtually and recorded, I need permission to record your voice and possible image. By selecting yes, you agree to be recorded in the context of this class. *
Submit
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