Interested in Techtonica

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If you're interested in participating in Techtonica's virtual technical coding training for women and non-binary adults seeking economic empowerment, please fill out this form and if you're eligible, we will contact you next time we have an open application process. If you have questions, please email info@techtonica.org.

First name *

Last name *

Email address (for more info and a reminder): *

Cell phone number with area code:

Are you very familiar and good with computers and the internet, can you type 30+ WPM, and do you know how to use a mouse/trackpad, browsers, and email? *

Yes

Do you agree to the following media release? Photographs, pictures, writing, assignments, recordings, likenesses, slides, movies, video, or other media coverage of my activities created or performed by me may be made in connection with my participation in Techtonica’s programs without compensation from Techtonica/Social Good Fund, activity-specific staff, its auxiliary organizations, and the officers, directors, employees, and agents of each of them. I also consent for the company to take, use, reuse, publish and republish any and all media coverage depicting the same (including compilations or other derivative works) both during and after involvement with the organization for any legal purpose and release Techtonica/Social Good Fund from all liability in connection with such activities. *

Yes

Which do you identify with the most? *

African-American/Black

East Asian (including Chinese, Japanese, Korean, Mongolian, Tibetan, and Taiwanese)

Hispanic/LatinX

Middle Eastern

Native American/Alaskan Native/First Nations

Pacific Islander

South Asian (including Bangladeshi, Bhutanese, Indian, Nepali, Pakistani, and Sri Lankan)

Southeast Asian (including Burmese, Cambodian, Filipino, Hmong, Indonesian, Malaysian, Mien, Singaporean, Thai, and Vietnamese)

White

Other:

Required

Which best describes your gender identity? *

Agender, genderblank, genderfree, genderless, gendervoid, non-gendered, or null gender

Genderfluid

Non-binary (you don't identify as a man or woman), feminine-adjacent

Non-binary (you don't identify as a man or woman), not feminine-adjacent

Cis Woman (your gender identity matches the sex you were assigned at birth)

Trans Woman

Trans Man

Cis Man (your gender identity matches the sex you were assigned at birth)

Which pronouns should we use for you? *

she/her

they/them

he/him

ze/zir

Other:

Required

Do you have a laptop that you can use during the program? *

Yes

Where do you live? *

(City and area/neighborhood)

Are you currently employed full time? *

Yes

Are your family/household income and net worth under $50,000? *

Yes

Why are you interested in learning technical skills like coding? *

Are you interested in Techtonica's full-time technical training? *

Yes

Maybe

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