Membership Form: We Can Change I.T.

We Can Change IT > Membership Form: We Can Change I.T.

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: ______________________________________________________________


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.