YWeb Career Academy Application

Please give a brief description of the reasons you feel make you good choice for acceptance into the program. How do you think you benefit from being in a program like YWeb.

Talents and Awards: *

List each, a description, the level, and the number of years of involvement.

Community Service Work:

List the type of work, your role, and hours per week of involvement.

Employment:

List the job, your title, description, hours per week, and dates of employment.

Are you currently employed? *

Yes

If YES, please check:

Full-time

Part-time

Temporary or LTE

Permanent

Apprenticeship

Do you currently have your own computer? *

Yes

What is the Make and Model of your computer? *

Family/Household Information

The information requested below is optional, but it may assist in the review of your admission. You are strongly encouraged to complete this section.

Is person who files Head of Household a women/female (she, her, hers) *

Yes

Total number of people in your household:

Please indicate your family’s gross income for the most recent tax year. Include both taxed and untaxed income. *

Do you have family obligations that keep you from participating in extracurricular activities?

Yes, I have to work to supplement family income.

Yes, I provide primary care for family member(s).

Other

If yes or other, please describe:

For Non-U.S. Citizen Only

City and Country of Birth

What is the status of your VISA?

What type of VISA?

If other:

I understand that this application is for admission only for the term indicated. I agree that I am bound by YWCA Madison's regulations concerning application deadlines and admission requirements. I agree to the release of any transcripts and test scores to this institution, including any SAT, Achievement Test, and ACT score reports. I certify that this information is complete and accurate. I understand that making false or fraudulent statements within this application or residency statement will result in disciplinary action, denial of admission and invalidation of credit or certificates earned. If admitted, I agree to abide by the policies of the YWeb and the rules and regulations of YWCA Madison. Should any information change prior to my entry into YWeb, I will notify YWCA Madison.

Events, activities, programs, and facilities of the YWeb Career Academy are available to all without regard to race, color, marital status, sex, religion, national origin, disability, age, Vietnam or disabled veteran status as provided by law and in accordance with YWCA Madison’s respect for personal dignity.

Yes, I understand and agree to the terms listed above.

No.

Thank you for submitting your application to YWeb Career Academy. A member of the YWCA Madison team will review your application and reach out to you with next steps.

Thank you,

YWeb Career Academy Team