Email: *

Full Name: *

first, last

School Name: *

Who is your school's Mouse Squad Coordinator?: *

Your Mouse Squad Coordinator's email address:

We'll contact your Mouse Squad Coordinator for a recommendation.

Grade: *

Home Address: *

Provide Full mailing address (example: 295 Lafayette Street, Apt. 403, NY, NY 10012)

Home Phone: *

xxx-xxx-xxxx

Your Cell Phone: *

xxx-xxx-xxxx (if you don't have one, add your home number here)

Date of Birth: *

Parent or Guardian Name: *

Parent or Guardian Phone Number: *

xxx-xxx-xxxx

Parent or Guardian's Email Address:

if your parent or guardian does not have an email, please skip.

What do you geek-out about?

Mouse Corps students are techies, artists, activists, hackers, innovators, fashionistas, tinkerers, and makers that love technology.

Tell us about your technology experience and interests: What are you really good at? What do you love about technology? What do you geek-out about?

What do you geek-out about?: *

What technology do you use - be honest!

We don't expect everyone to be experts - we like to build diverse teams with different skills. Let us know which of the following you already know, which you would LIKE to know, and which you are not interested in.

Rate your experience with the following: *

	I have no experience with this.	I have a little experience but don’t know it well.	I have a lot of experience.	I am an expert!	I don't have experience with this, but I really, really want to learn!
Microsoft Word
Microsoft Excel
Powerpoint or Keynote
Email
Internet research (I can find answers to any question on the internet/google)
Mac Computers
Windows Computers
Linux Computers
Facebook
Twitter
Unicorn Hunting
Video Games
Google Docs
Website Design/Coding
Taking apart a computer and putting it back together
Photoshop/Graphics
Video Editing
Underwater Ice-skating
Troubleshooting (Fixing computer problems)
Skype/Oovoo/Video chat
Robotics
Programming (software)
Mobile Technology (Android/iPhone/Blackberry/Windows Phones)
Blogging
3D printing and design
Cameras (still or video cameras)

My Values

Each Mouse Corps Candidate pledges to uphold a series of core values.

As a Mouse Corps Candidate, you commit to:

Community: using skills, creativity, and knowledge to create a positive impact locally and globally
Growth:being responsible for my own learning. aspiring to constantly evolve and improve personally, professionally, and ideologically
Team: growing ideas and actions collaboratively
Leadership: contributing to the activities of Mouse Corps, the community, and your greater professional environment in positive, productive, and meaningful ways
Safe Space: Creating a safe space at Mouse, where everyone is able to be themselves, without fear of being made to feel uncomfortable, unwelcome, or unsafe

Choose one of the Mouse Corps values above and tell a story in which you upheld or learned the importance of that value. : *

In Mouse Corps, you'll spend the entire year in a small team with other students. Each person on a team brings a unique important perspective, skill-set, and personality. Check the boxes below that best describe your team-work style (Try to select no more than 3).

My Start-Up

If you were going to pick an issue in your local/global community and create a start-up organization to address this issue, what would it look like?

Your start-up can be anything from a local lemonade stand, to a large software corporation, from a global non-profit to small business. Be Creative!

My Start-Up: *

Time Commitment

Mouse Corps meets every Tuesday throughout the school year.

To participate in Mouse Corps, you must be available to attend after-school workshops starting at 4:00pm in Manhattan. Workshops are almost always on Tuesdays, with occasional Saturdays (no more than a few times a year).

NOTE: All meetings are required. You will not be allowed to return if you miss more than 3 workshops with out contacting us in advance with a reasonable excuse.

Please let us know if you have any commitments after-school that will make it hard for you to attend meetings on time.

My Schedule: *

Sign up for the Mouse Corps Open House

All interested applicants must attend the Mouse Corps Open House event on Tuesday, October 7th from 4pm - 5:30pm. At the open house, you will meet the returning Mouse Corps students and learn more about the program. The event location will be emailed to you once you have applied.

Mouse Corps Open House: *

I will be there!

I can not attend.

How did you find out about Mouse Corps?

How did you find out about Mouse Corps?:

Bonus!

Anything else you want to share to let us know about who you are and why this creative program is right for you? share anything you want here! (not required!)

Bonus!:

Ok, you are done! Good Luck!

We will send you a reminder about the open house.

Mouse Corps Application

Mouse Corps is a youth-centered design and technology program that develops emerging leadership, professional and technical skills of select high school students from Mouse Squads across NYC.

How to Apply

The Legacy Project

Technology Mentoring & Apprenticeships

Project Presentation

Applications are due Tuesday Oct 7tht!

Good Luck!