Industry Corps Application

PARTICIPANT INFORMATION

First Name (Legal)

Last Name (Legal)

Preferred Name/Nickname

What are your preferred pronoun(s)?

Add your pronouns below

Birthdate

With what gender do you self-identify? (ie. Male, female, non-binary, etc.)

Add your gender identity below

Are you Hispanic or Latino/a/x?

With which racial group(s) do you self-identify? Check all that apply.

With which ethnic group(s) do you self-identify? Please list any and all group(s).

Is English your first language?

Yes

No

What is the language spoken at home?

Personal Email Address (please do not use your high school email address)

Cell Phone Number

Primary Street Address

Country

Street

City

Region

Postal Code

In which Boston neighborhood do you live?

SCHOOL INFORMATION

Did you attend Boston Public Schools?

Yes

No

No, I have a GED/HiSet

Select your Boston Public Highschool

Type the name of your high school here:

What is your BPS ID number?

When did you get your high school diploma or equivalent?

Have you completed a college course or participated in dual enrollment?

Yes

No

How many college credits have you accumulated, and in what courses/fields? (Verification must be provided or determined) Please describe

Since you answered Other above please provide the name of the community-based organization you are involved with.

Since you answered Other above please describe where you heard about Industry Corps.

HOUSEHOLD INFORMATION

First Name of one (1) Parent/Guardian

Last Name of Parent/Guardian listed above

Cell Phone Number for Parent/Guardian (if applicable)

Home Phone Number for Parent/Guardian (if applicable)

Email Address for Parent/Guardian (if applicable)

The following statement(s) applies to me (check all that apply):

I am the first in my family to attend college

My sibling(s) is/are the first in my family to attend college

My parent(s) earned their bachelor's degree outside of the US

None of these statements apply to me or my family

PERSONAL DOCUMENTS

I can provide my social security card, if necessary.

Yes

No

I have a government issued Photo ID (ie. Driver's license, US Passport, Mass ID).

Yes

No

If available, upload your most recent report card or transcript below. A final transcript will be required for admittance into the program.

Please select the Pathway that most aligns with your goals and aspirations:

PERSONAL STATEMENT

Please provide a statement explaining why you are interested in participating in Industry Corps. Please share what your future college and career goals are in the pathway you have selected.