Please complete the following membership form to join We Can Change I.T. and gain access to our guidance, mentorship, and support programs for IT professionals. By becoming a member, you will be part of a community dedicated to empowering individuals in the IT industry and fostering growth and success.
Personal Information
Full Name: _______________________________________________________________
Date of Birth (MM/DD/YYYY): //________
Gender: [ ] Male [ ] Female [ ] Non-binary [ ] Prefer not to say
Address: ________________________________________________________________
City: ______________________ State: _______ Zip Code: ___________
Phone Number: __________________________
Email Address: ____________________________________________________________
Occupation: ______________________________________________________________
Education
Highest Level of Education Completed: _______________________________________
Degree/Field of Study (if applicable): ________________________________________
Current School/College/University (if applicable): ____________________________
Information Technology Background
Current IT Role/Position (if applicable): ____________________________________
Years of Experience in IT Industry (if applicable): _____________________________
Certifications (if any): _____________________________________________________
Areas of IT Interest/Expertise: _____________________________________________
Membership Preferences
Membership Level: [ ] High School Student [ ] College Student [ ] IT Professional [ ] Career Transition (Non-IT to IT) [ ] Other: _____________________________________________________________
Areas of Interest (select all that apply): [ ] Guidance and Mentorship [ ] Job Advancement [ ] Life Coaching [ ] Physical Fitness [ ] Certification Study Sessions [ ] Resume Building [ ] Communication Skills Development
By submitting this form, I agree to the terms and conditions of We Can Change I.T. membership and understand that the information provided will be used for communication and program-related purposes.
Signature: ___________________________ Date: //________
Please submit your completed membership form.