Young Tech Innovator — Program Intake Form (K–12)

Fall 2026 Cohort registration is now closed. You can apply for the Spring 2027 Cohort. Thank you for your interest in the Young Tech Innovator Program!

This form collects student and parent/guardian information for participation in our Young Tech Innovators Program. Information will be used for eligibility verification, program participation, and reporting for approved funding partners including Denver Foundation, CHF, DPS, and MySpark.

Student Information

Student Full Name *

Other Child's Name *

Age *

Other: *

Current School Name *

School District *

Is your school part of Denver Public Schools (DPS) *

Yes

No

Date Of Birth *

Residency Verification

Full Home Address (Street, City, State, Zip) *

Do you currently live in the City & County of Denver? *

Yes

No

Have you lived in Denver for at least 6 months? *

Yes

No

Does the student attend a Denver High School? *

Yes

No

Financial Need Verification

Household qualifies for (Select all that apply) *

Other:

Program Participation

Service Areas Participating In

Academic Planning & Support

Career & Postsecondary Exploration

Financial Aid & Scholarship Support

Individualized Mentorship

Postsecondary Preparation

Wellness & Cultural Identity Programming

Parent/Guardian Information

Parent / Guardian Name (if under 18) *

Parent / Guardian Email *

Parent / Guardian Phone Number *

How did you hear about us?

Consent Statement:

By submitting this form, I give permission to the Colorado African Innovation & Cultural Center (CAICC) to collect and securely store my information for program participation, eligibility determination, and reporting purposes related to youth programming and funding partners including Prosperity Denver Fund and MySpark. Information will not be sold and will only be shared with licensed providers and approved partners directly involved in service delivery. *

Yes

No

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