Brightfield Tech Academy
Application

Brightfield Tech Academy Student
Application

Please use this form to sign-up for Brightfield Tech Academy. This will add you to the waiting list to enter the program. At this time we cannot provide estimates on when your class begins, but we will contact you at least 45 days before it is scheduled in order to begin the pre-work.

The information in this form will be used by KentuckianaWorks, the Workforce Development Board of the Kentuckiana region, to determine eligibility for the Code Louisville program and for anonymous reporting purposes on workforce and training programs in the Greater Louisville region.

IMPORTANT NOTE: If you have already applied before using this form, do NOT apply a second time. Doing so will overwrite your first application, moving you further back in line. Please contact apply@codelouisville.org if you have questions about your application.

* Required

Gender

Ethnicity

Race

Are you currently employed in the technology industry or interested in gaining employment in a technology-related field?

Are you fluent in English?

Do you have a disability?

What is your employment status?

Have you ever been convicted of a felony?

making yes will not disqualify you from the program

Are you currently experiencing a housing crisis (e.g. homeless or living in a temporary shelter/residence)?

Please check any of the following services that apply to you as of today's date:

Do you consider yourself economically challenged?

What is your housing situation

Temporary Housing – living in emergency shelters, motels, hotels, trailer parks, cars, parks, public spaces, or abandoned buildings, and those sharing the housing of other persons due to loss of housing, economic hardship, or a similar reason. Transitional Housing – a project designed to provide housing and appropriate supportive services to homeless persons to facilitate movement to independent living. The housing is short-term, typically less than 24 months.

Highest Level of education completed

Are you currently enrolled in a college or university and/or pursuing a degree?

Do you have a laptop or desktop computer?

access to a computer is required to participate in the program. If you do not have one, Mark No, and someone from our team will termine need and possibly connect you with resources if you qualify.

Do you have consistend access to stable internet?

Coursework and all class meetings are held virtually, and you will need Internet access to participate.

How do you rate your computer skills

Novice 1 2 3 4 5 Expert

1) I can access email 2) Basic: I can access common applications, such as Word Documents 3) Intermediate: I use computers every day and consider myself tech-savvy 4) Advanced: I am well advanced in using computers 5) Expert: I am well established in using professional tech skills such as software development or supporting business computers

Are you willing to commit 10-20 hours of work to the program?

Code Louisville is an accelerated program that requires a considerable time investment each week for successful completion.

What are you interested in learning?

Please note, this is not a selection of what class you want, just so we can understand what our participants are interested in learning.

I agree, understand and/or acknowledge that:

The submitted information above is true and complete to the best of my knowledge. The submitted information will be entered into the Brightfield database.Brightfield will NOT report my identifying information, any data reported will be void of name, address, or other identifying information. Brightfield has my permission to use the above information for follow-up (enrollment) activities related to the program. Neither Brightfield Tech Academy discriminate on the basis or race, color, national origin, sex, religion, age or disability in employment or provision of services.