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Web Tech Nomination Form
Ashtabula County's Web Tech Student Nomination Form
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* Indicates required question
Nominee/Student First Name
*
Your answer
Nominee/Student Last Name
*
Your answer
Nominee/Student Phone
*
Your answer
Nominee/Student Email
*
Your answer
Does the nominee live in Ashtabula County?
*
Yes
No
Why will the nominee be a good fit for the Web Tech Program?
*
Your answer
Sponsorship: Please check all that apply
I am an employer sponsoring the nominee through this program. I am willing to commit $2,000 to upskill my employee.
I am an employer of the nominee, but I'm unable to sponsor this individual financially.
The nominee is employed, but the employer is unable to sponsor.
The nominee is unemployed.
Other:
If Nominating Someone other than Yourself...
If you are nominating someone other than yourself (employee, friend, relative, etc), please fill out the following information
Your Relationship to Nominee
I am a co-worker or employer of the nominee
I am a relative
I am a friend
Other:
Your Name
Your answer
Your Email
Your answer
Your Phone
Your answer
Your Company
Your answer
Is the nominee aware of this nomination?
Yes
No
Other:
Clear selection
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