Boardwalk Academy Statement of Interest Form

Please fill out the form below to state your interest in attending Boardwalk Academy.

Name*
First Last
Address*
Street Address City State ZIP Code
Personal Email Address
Phone*
Note: The next steps in our recruitment process is for a member of our team to call you to schedule a phone or in-person interview. Please list the number that we should call to reach you for this purpose. And if needed, use the space below to share any special instructions or other information that we need to know to successfully connect with you.
Example: I am only available at this number Mon-Fri, from 5:00 pm – 9:00 pm.
Gender Age Race / Ethnicity
In which of the following categories does your poverty-related, lived experience align
- Eviction or Homelessness
- Food insecurity. Not enough money to feed your family
- Unemployment/ Underemployment
- No access to quality, affordable childcare
- Other
If Other, please explain:
If accepted into our 2020 Boardwalk Academy, which of the following supports will you need?
- Transportation to and from training
- Childcare
Number of children
Age(s) of child(ren)
- $25/hour stipend | Note:stipends are available for all attendees unless this professional development opportunity is employer sponsered.
Why are you interested in participating in our Boardwalk Academy?*
Are you interested in serving as a volunteer leader for any specific non-profit organization in Dane County? If so, please list the names(s) below.

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