Apple Foundation Program Application

Apple Foundation Program Application

Apply to the Apple Foundation Program by providing your personal, demographic, and professional information.
Name

First NameLast Name
Personal Email
example@example.com
Cell Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Birth

MonthDayYear
Date
Residential Address

Street Address

Street Address Line 2
CityStateZip Code
County
Learning Location
Sumter County in York

Hale County in Greensboro

Macon County in Tuskegee

Perry County in Uniontown

Dallas County TBD
Is this your mailing address?
Gender

Other
Race (Select all that apply)

Other
Are you Hispanic/Latino?
Marital Status
- Highest Completed Education
- Are you an HBCU Grad/Affiliated?
- HBCU
- Employment Status
- Employer/Company Name
- Industry/Nature of Business
- Position/Title
- Devices you use (Select all that apply)
- How confident are you in using technology?
  
  1
  
  2
  
  3
  
  4
  
  5
  
  1 is Not confident, 5 is Very confident
- Professional Goals - Please take a moment to briefly describe your professional goals.
- Please list some technical skills you hope to acquire or improve during this course.
- Do you require any special accommodations (e.g., preferential seating, hearing or vision consideration)?
- If you were referred by an Ed Farm Mentor or Coach, please select their name.
- Program Name
- Program Status
- By submitting this form, you grant permission for Propel Education and its subsidiaries, including but not limited to Ed Farm, to use your image and likeness in recordings and for educational or promotional purposes.
- Captcha
Should be Empty:

Apple Foundation Program Application

By submitting this form, you grant permission for Propel Education and its subsidiaries, including but not limited to Ed Farm, to use your image and likeness in recordings and for educational or promotional purposes.