AGE:

ETHNIC BACKGROUND:

LANGUAGES SPOKEN:

MAJOR(S)/MINOR(S):

DAYS AND HOURS AVAILABLE ON WEEKDAYS:

ARE YOU AVAILABLE ON WEEKENDS?
Yes                 No

RELEVANT WORK EXPERIENCE:

WHAT AREAS DO YOU WANT TO FOCUS OR LEARN MORE ABOUT?
Behavior Research
Education
Health
Policy and Advocacy
Youth
Other

WHAT THREE SKILLS AND TALENTS DO YOU DO BEST?

WHAT SKILLS AND TALENTS WOULD YOU MOST LIKE TO LEARN AT OCAPICA?

WHAT COMPUTER APPLICATIONS ARE YOU COMFORTABLE WITH?