Apply — Career Launch Program

01 Personal & Background

Full Name *

Email Address *

Phone Number *

College / University *

Degree & Graduation Year *

How did you hear about us? *

Any prior coding experience? (Optional)

Why do you want to join this program? *

02 Program Fit & Skills

Your main goal for this program? *

Build a job-ready portfolio Learn industry workflow Start freelancing

Technologies you are familiar with? *

HTML CSS JavaScript PHP MySQL Git

Quick Assessment

Have you built websites before? *

Rate your current coding level *

03 Declaration

I hereby declare that the information provided in this application is true and correct to the best of my knowledge. I understand that this program requires commitment, daily attendance, and active participation in project work.

I agree to abide by the rules and regulations of the AffixxMedia Career Launch Program and understand that my selection is based on the quality of my application and my commitment to the 30-day curriculum.

Your Digital Signature *

Click to sign

I am serious about this program

Your Application

01 Personal & Background

02 Program Fit & Skills

Quick Assessment

03 Declaration

Type your signature