TAIF SCHOLARSHIP APPLICATION Scholarship Application CLASSES OF INTEREST *Check all that apply Data Visualization Certificate Business Intelligence Certificate Data Engineer Certificate Machine Learning Certificate Fundamentals of Data Science Certificate CONTACT INFORMATION State*AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Format: 123-123-1234 *Or, verify primary phone number Format: MM/DD/YYYY DEMOGRAPHIC DATA HOW DO YOU IDENTIFY? Male Female Genderqueer/Non-Binary I prefer not to answer ETHNICITY Caucasian Hispanic Black or African American American Indian or Alaska Native Asian Native Hawaiian or Other Pacific Islander An Ethnicity not listed above Multiracial MILITARY STATUS Active Duty Reserves Veteran No Military Service INCOME RANGE Less than $20,000 $20,000 to $34,999 $35,000 to $49,999 $50,000 to $74,999 $75,000 to $99,999 Over $100,000 EDUCATION LEVEL High School Some College Tech/Trade School Associates Degree Bachelors Degree Masters Degree PhD On-the-Job Training Self-Taught Not required, but helps us with future marketing and potential partnerships. DEMOGRAPHIC DATA Note: Our mission at the TAIF is to expand and diversify the data science community. Our goal is to award a significant portion of scholarships (at least 75%) to low-income individuals, women, and/or racial and ethnic minorities so the data science field better represents the communities it serves. Being none of these is not a precluding factor for an award. *Any Demographic Data provided is available only to selection committee. Any reporting will be done at the macro level. Where did you hear about our scholarship fund? * Are you currently working with anyone at: * Contemporary Analysis Omaha Data Science Academy Nebraska Tech Collaborative AIM Code Black Western Iowa Community Foundation None Have you applied to WIOA? * Yes No Are you willing to match at least some portion of the scholarship for your education? * Yes It is simply not an option at this time If yes, how much? Tell the selection board how a certification from the ODSA is going to improve your life. * STUDENT AGREEMENT AND SIGNATURE * The student, by signing this Agreement, agrees that, to the best of their ability the information provided on this sheet to be true. Date of Signature * Digital Signature Acceptance * I Understand and Agree CAPTCHA SUBMIT If you are human, leave this field blank.
