AccessComputing Team Application

The Department of Computer Science and Engineering at the University of Washington and DO-IT (Disabilities, Opportunities, Internetworking, and Technology) sponsor the AccessComputing project for the purpose of increasing the participation of people with disabilities in computing careers. It is funded by the National Science Foundation (Grant #CNS-0540615, #CNS-0837508, and #CNS-1042260). AccessComputing provides a nationwide resource to help students with disabilities pursue computing fields and computing educators and employers, professional organizations, and other stakeholders develop more inclusive programs and share effective practices.

Students with disabilities can become part of the AccessComputing Team and engage in an online community of peers and professionals as they transition to college, graduate school, and employment. AccessComputing will also identify opportunities for paid internships and research, especially with college students.

The AccessComputing Alliance is recruiting high school and college students with disabilities who are interested in computing careers to join the AccessComputing Team. AccessComputing student participants will engage in experiences that will enhance their college and career success.

AccessComputing Team Eligibility

High school or college students with disabilities in the United States are eligible to be AccessComputing Team members. Participants must demonstrate an interest and/or aptitude in pursuing professional careers in computing fields. These fields include systems designers, computer scientists, information professionals, software developers, information systems analysts, technology teachers, and computing faculty. AccessComputing participants must have an email account and access to the Internet.

Participation Agreement

As a member of AccessComputing, you must actively communicate with AccessComputing staff, peers, and mentors. To remain on the AccessComputing team and to be eligible for work-related opportunities, such as internships, you must be an "active participant." As an "active participant," you are expected to:

1. Log on to your email account at least once per week and read and respond to email messages.
2. Attend AccessComputing events when possible.
3. Notify AccessComputing staff of any changes in your contact information, or your ability to participate in AccessComputing internships and activities.

Application Requirements

Please contact DO-IT if you would like assistance in completing any portion of your application.

1. Application Form
   Complete the attached two-page AccessComputing Student Application form. This form must include a parent or guardian signature if you are under 18 years of age.
2. Paragraph
   Submit a paragraph or two with your application explaining why you are interested in participating in an AccessComputing internship and mentoring and how participation will help you reach your career goals. Include school honors, extracurricular and community activities, work-related experiences, and any other relevant information about yourself.
3. Recommendation
   Submit one letter of recommendation from a teacher, faculty member, or someone who has worked with you closely or provide the name and contact information of a person that can provide a reference for you.
4. Resume
   Submit an up-to-date copy of your resume.

Submitting AccessComputing Student Applications

Applications are accepted on an ongoing basis. The AccessComputing Team application packet may be submitted via postal mail, fax, or email.

AccessComputing

c/o DO-IT
University of Washington
Box 354842
Seattle, WA 98195-4842
accesscomp@uw.edu
www.uw.edu/accesscomputing/
206-685-DOIT (3648) (voice/TTY)
888-972-DOIT (3648) (toll-free voice/TTY) WA, outside Seattle
509-328-9331 (voice/TTY) Spokane
206-221-4171 (fax)
Co-Director: Richard Ladner, Ph.D.
Co-Director: Sheryl Burgstahler, Ph.D.

Copyright © 2013, 2012, 2011, 2010, 2009, 2008, 2006 University of Washington. Permission is granted to copy these materials for educational, noncommercial purposes provided the source is acknowledged.

AccessComputing Team Application Form

Student Data

• First and last name
• Address (street, city, state, zip)
• Phone number(s)
• Email address
• Name and address of parent/guardian (if under 18)
• Parent Email (if under 18)
• Parent Phone (if under 18)
• Gender
• Date of birth
• Disability
• Ethnicity (select one):
  ___Hispanic or Latino
  ___Not Hispanic or Latino
• Race (select one or more):
  ___American Indian or Alaska Native
  ___Asian
  ___Black or African American
  ___Native Hawaiian or Pacific Islander
  ___White
• Veteran or military service (Yes/No)
• Describe any accommodations you may need to participate in an internship
• How did you hear about AccessComputing:
  ___Opportunities! Newsletter
  ___other publication
  ___email announcement
  ___website
  ___poster
  ___presentation/meeting
  ___friend
  ___other:________________

Academic Background

• Academic level currently enrolled in:
  ___high school
  ___community college
  ___technical college
  ___four-year university/college
• School name
• City
• State
• Anticipated graduation date
• Major(s) (if applicable)
• Specific career interests

Employment/Internship Information

Citizenship (select one):
___U.S. citizen
___Permanent resident ("green card")
___U.S. national (born in American Samoa/Swains Island or descendant of U.S. national)

If you are not a U.S. citizen, do you have a right-to-work permit? ___Yes ___No.
Where are you able to work in an internship or other work-related experience?

Publication Guidelines

Please note that, on occasion, AccessComputing Team members are featured in printed and web-based materials such as DO-IT News. As an AccessComputing Team member, you agree to allow AccessComputing staff and Alliance partners to publish information including, but not limited to, your first name, city and state of residence, name of school, employer, disability, and interests. This information may be used for program reporting and data analysis. As an AccessComputing Team member, you also waive any right to inspect or approve the finished publication or the eventual use for which it might be applied. Although we will work with AccessComputing members to plan and initiate disclosure of their disabilities to potential employers, schools, or other organizations in conjunction with AccessComputing activities, your disability may be disclosed or implied.

Use of Photographs and Video

Some AccessComputing events and work-related experiences are photographed and/or videotaped. When you participate in these activities you may be photographed and/or videotaped. As an AccessComputing Team member, you agree to give AccessComputing staff and Alliance partners permission to copyright, distribute, sell, broadcast, duplicate, exhibit and/or use film, photographs, and/or printed information without limitation for general education, information dissemination, and research purposes in video, printed publications, and the Internet. In addition, you waive any right to inspect or approve the finished publication or other product in which your image/information might be used.

Indicate whether you do not give permission to be included in pictures or videos:

_________________________

I have read and agree to the expectations listed in the Participation Agreement, Publication Guidelines, and the Use of Photographs and Videotape guidelines as indicated above.

I understand that DO-IT may request a criminal background check of program participants. I agree to report to DO-IT any past convictions or present charges that relate to minors or vulnerable adults. Further, I agree to report to DO-IT any future charge or conviction at teh time it occurs.

Signature of AccessComputing Team applicant:

Printed name of applicant:

For Applicants Under the Age of 18 Years

I give permission for my son/daughter to participate in AccessComputing activities and events. I have read and agree to the above conditions, including the Participation Agreement expectations, Publication Guidelines, and the Use of Photographs and Video guidelines as indicated above.

Signature of parent/guardian:

Printed name of parent/guardian:

Further Information

If you have questions about AccessComputing or this application, please contact DO-IT at 206-685-DOIT (3648) voice/TTY; 888-972-DOIT (3648) toll free voice, TTY, Washington, outside Seattle; or accesscomp@uw.edu. Mail, fax, or email your completed application to DO-IT, University of Washington, Box 354842, Seattle, WA 98195-4842; 206-221-4171 (fax); accesscomp@uw.edu.