MAKER MULTIPLIER Application

MAKER MULTIPLIER Application
We’re excited to share more about our program, so here are the next steps!
1. Complete the application below.
2. You will receive an email with a link to watch a short MAKER MULTIPLIER video overview with insights and options for your involvement.
3. After you view the video, we will follow up with you one-on-one in a pre-scheduled meeting or call to answer any questions and learn more about you.
Whether you just want to share your journey on our MakerMultiplier.com website or wish to engage further in schools in our community, we will help connect you to opportunities to inspire the NextGen!
First Name*
Last Name*
Employer Information
Employer*
Street Address*
City*
State*
5-Digit Zip Code*
About You
Email*
example@example.com
Cell Phone Number*
Please enter a valid phone number.
Town of Residence
LinkedIn Profile URL
Job Title*
Relevant Past Roles*
Our work in Maker Multipliers and at CCAT is to increase awareness of Manufacturing career paths for all communities, schools and individuals, especially for those historically underrepresented like females and people of color. If you are comfortable sharing, please provide your racial and ethnic background.
Do you have any prior experience at your company, or personally, interacting as a mentor or ambassador representing manufacturing in education settings? If Yes, please explain.
Specific Expertise - Select all that apply*

DesignProductionInspectionAdministrativeSupervisoryOther
Industry Experience - Select all that apply*

AerospaceAutomotiveConsumer Product GoodsElectricalEnergyFood/BeverageMedical/BioscienceOther
Introductory Call

As part of our screening process, you will receive a link to a short orientation video, and we will then schedule an initial introductory call to learn more about you and answer any questions you might have.
What type of call would you prefer?*

Microsoft TeamsZoomPhoneOther
What is the best time of day to schedule a call?*

9 a.m. to 11 a.m.11 a.m. to 1 p.m.1 p.m. to 3 p.m.3 p.m. to 5 p.m.Other
By submitting this form, you acknowledge that the information provided will be collected by the Connecticut Center for Advanced Technology, Inc. (CCAT).

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MAKER MULTIPLIER Application

Employer Information

About You

Introductory Call