ASE Preliminary Application

Thank you for applying for the 2008 ASE Program. Please take the time to read the “Application Instructions” before you begin the application. You will need to complete the entire form in one sitting, so please be prepared to answer the four narrative questions. If you have any questions about this application or the program, please contact ASE at 503-725-2334, ase@saturdayacademy.org.

Capitalization, spelling, and proper formatting will count in your favor on this application. Your answers are sent to the mentors exactly as you submit them, we will not spell check them for you or correct capitalization and formatting.

* First Name

Middle Initial

* Last Name

* Gender:

Male

Female

* Mailing Address

Street Address (If different from mailing address)

* City

* County (not country!)

* State

* Zip Code

* Home Phone (format 555-555-5555)

Cell Phone (format 555-555-5555)

* Current School (full name)

* Current Grade:

9th

10th

11th

* Birth Date (mm/dd/yyyy)

* Email Address

* Are you a US Citizen?

Yes

No

If "no," do you have Permanent Residency status?

Yes

No

Parent Information

Parent/Guardian #1 Information

* First Name

* Last Name

* Employer

Work Phone (format 555-555-5555)

Cell Phone (format 555-555-5555)

Email Address

Home Address (only complete if their address is different from your own)

City

State

Zip Code

Parent/Guardian #2 Information (if not applicable, write n/a in the required fields)

* First Name

* Last Name

* Employer

Work Phone (format 555-555-5555)

Cell Phone (format 555-555-5555)

Email Address

Home Address (only complete if their address is different from your own)

City

State

Zip Code

Optional Questions

Some of Saturday Academy's costs are underwritten by generous foundations, corporations and individuals. They ask that we supply statistical information about the students we serve. Your answers to the questions below are optional. Responses will be kept strictly confidential.

What ethnic group or groups do you identify with?

If you selected American Indian, what is your tribal affiliation?

Do you speak a language other than English at home?

No

Yes

If yes, please specify the language

Are you eligible for the Federal Free or Reduce Price School Lunch Program?

Yes

Eligible, but do not participate

Not Eligible

Yearly Family Income (ASE may have grant funds to provide an additional stipend to accepted students from households with "moderate" or "low"yearly family income. Proof of household income may be requested.)

Is anyone in your immediate family a college graduate?

Yes

No

Detailed Questions

Most ASE positions involve some work with computers. Please mark the following (more than one answer is allowed) if you are proficient in using it:

List any other computer skills or programs you are comfortable with.

* Do you have a valid driver's license?

Yes

No

* Do you anticipate any difficulty with transportation to and from your apprenticeship each day?

Yes

No

* Please indicate any health conditions or disabilities that should be considered in the workplace, if none, put none in this field:

* How did you first hear about ASE?

Have you participated in other Saturday Academy programs (mark all that apply):

Classes & Workshops

LEAP

AWSEM

Narrative Questions

* List and briefly describe particular skills you have developed, your hobbies (woodworking, model making, crafts, hiking, etc.), projects, relevant employment, volunteers experiences, etc. Include any activities that demonstrate your initiative, and ability to work responsibly and creativity.

* Give an example of a challenging problem or project, and how you solved it or attempted to solve it.

Narrative Questions, Page 2

* Explain your interest in the ASE Program, what you hope to gain by participating, and why it is important to you.

* Past participants of the ASE Program have said that three of the most important abilities an apprentice should have are the ability to "put up with routine work," "deal with uncertainty," and "dig information up on your own without a teacher telling you what homework to do." Please comment on these abilities as they pertain to you.

*

I certify all statements made in this application are true to the best of my knowledge.

* Indicates Response Required

Word processing	Database work	Spreadsheets
Desktop Publishing	Web Design	Visual Studio
C++	PERL	AutoCAD
Linux	Mac	Unix
Soldering	Wiring	Troubleshooting
Repair/Replacing Hardware	Circuit Board Work