Student Computing Careers Form

Student Computing Careers Form

Student Identification

Student Name:    Date of Birth:

Student ID:    Grade / Program:

Contact Information

Academic Information

Current GPA:    Expected Graduation:

Full-time    Part-time    Online / Hybrid

Career Interests and Preferences

Please indicate the computing career paths you are interested in (select all that apply):

Software Engineer    Data Scientist    Cybersecurity    IT Support

DevOps    UX/UI Design    Systems Administration    Other:

Internship    Part-time Employment    Full-time Employment    Co-op

Skills, Experience, and Certifications

Please indicate programming languages, tools, and approximate years of experience:

Python ()   Java ()

JavaScript ()   SQL ()

Experience Summary

Work Authorization and Background

Please indicate your work authorization and background consent:

I am legally authorized to work in the country of placement without sponsorship.
I require employer sponsorship to work.

Certain employer or placement opportunities may require criminal background checks, driving records, or fingerprinting. By checking the box below, you authorize the program to initiate such checks as required by third-party hosts.

I authorize the institution to initiate background checks and understand that placement is contingent on results where required.

Privacy, Data Use, and Releases

By signing this form, the student consents to the retention and use of information provided on this form for the purposes of career advising, placement matching, recruiting events, alumni tracking, and communications. Information may be shared with prospective employers, internship hosts, or program partners solely for recruitment and placement activities.

I consent to the sharing of my resume and contact information with prospective employers and program partners as described above.

Media Release: I grant permission for photographs, video, and written quotes taken in connection with program activities to be used by the institution for educational and promotional purposes unless I opt out below.

I consent to media use.   I do not consent to media use.

Emergency & Health Information

Accessibility and Accommodations

If you require accommodations for interviews, placements, or program activities, indicate and provide details below. The institution will engage in an individualized assessment to provide reasonable accommodations.

I request accommodations    I do not request accommodations

Attachments

Acknowledgments and Certification

By signing below, I certify that the information provided on this form is true and accurate to the best of my knowledge. I understand that misrepresentation may affect my eligibility for program services or placement. I acknowledge that participation in career services and placement activities does not guarantee employment. I release the institution from liability for decisions made by third-party employers or hosts. I agree to comply with applicable student conduct policies and program requirements. If applicable, I consent to required background checks as described above.

Are you under the age of 18?   Yes    No

If the student is a minor, a parent or guardian must sign this form. The signer below certifies authority to sign on behalf of the student where required.

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