Student Registration

1. Age & Contact Information

Applicants under 18 require a parent or guardian contact. Applicants under 13 must have a parent or legal guardian complete this registration on their behalf.

Age Group

Student / Learner Full Name

Student Email Address

Required for applicants age 13 or older. Applicants under 13 should use the guardian contact section.

Student Phone Number

Required for applicants age 13 or older.

City

State / Province / Region

Country

ZIP / Postal Code

Parent / Guardian Full Name

Required for applicants under 18.

Parent / Guardian Email

A secure consent request will be sent to this address.

Parent / Guardian Phone

Required for applicants under 18.

I am the parent or legal guardian completing this registration on behalf of an applicant under 13.

Required for applicants under 13.

2. Education & Current Status

School, College, Employer, or Organization

Current Education Level

What best describes you?

Current Technology Experience

5. Communications & Acknowledgment

Please review the TeckyVan Privacy Notice before submitting.

Program Updates

Yes, keep me informed. No, thank you.

I have reviewed the TeckyVan Privacy Notice and understand how information submitted through this registration will be used to evaluate registration, communicate about programs, and administer relevant services.

I confirm that the information provided is accurate to the best of my knowledge and understand that registration does not guarantee placement in a particular program, internship, or job.

Please do not submit Social Security numbers, driver’s-license numbers, financial information, medical diagnoses, or background-check credentials through this form.

Student & Learner Registration

1. Age & Contact Information

2. Education & Current Status

3. Technology Interests

4. Participation & Availability

5. Communications & Acknowledgment