Reboot Scholar Registration Form

Reboot Scholars intake Form

The mission of Reboot Representation is to make collective investments in the success of Black, Latina, and Native American (BLNA) women and girls in emerging technological fields.

If you identify as a woman or non-binary undergraduate student who is Black, Latina, or Native American and pursuing a computing degree, or if you are a participant in a Reboot-funded program: YOU ARE A REBOOT SCHOLAR!*

Our vision is to create educational, economic, and personal growth opportunities for every Reboot Scholar, ensuring equitable access to these opportunities. To achieve this, we strive to understand the diverse backgrounds of our scholars, including gender, race, ethnicity, and other relevant demographic information, to measure and advance equitable access to our programs and resources. Representation matters, and Reboot is committed to collecting and utilizing this information in a way that genuinely reflects our community and fosters meaningful engagement.

 

*Please complete this form to learn more about how to become a Reboot Scholar!

Are you over 18 years of age or over?
Name
Name
First
Last
Do you identify as a first generation college student?
‘First Generation’ means that neither of your parents have completed a four-year university degree.
Do you identify as a member of the LGBTQ+ community?*
Which of these racial identities applies to you? (Please check all that apply.)
The Reboot team will NEVER share your cell phone number or address without your consent. We would like your mailing address to send you some swag and text message reminders (you can opt-out at any time).

Permanent Address (where we can send you swag)

Which Reboot program(s) are you participating in? (Please check all that apply.)
Which of the following military affiliations apply to you? (Please check all that apply.)
Which of the following parent / guardian / caretaker identities apply to you? (Please check all that apply.)
How did you hear about Reboot? (Please check all that apply.)
Terms & Conditions