Biomedical & Information Technology Inquiry Form
Thank you for your interest in Biomedical and Information Technology Careers Programs. Registration for the upcoming 2022 cohorts is CLOSED.
Please complete the following information request to receive email updates
with information about upcoming recruitment for next available cohorts.
Which Program are you interested in?
JAS IT or JAS Bio
Primary Phone Number
Date of Birth
Are you eligible to work in the U.S.?
Including yourself, how many people live in your household?
What is the combined Gross Annual Income for your household?
What is the highest education you have completed?
High School Diploma
GED/Hiset or equivalent
Verifiable with an official transcript or diploma
Have you attended some college, but not completed a degree?
What (Country) did you complete your highest degree of education?
Any other helpful information about your experience (prior training)?
How should we contact you?
How did you hear about us?
Boston Career Link
Cambridge Employment Program
Cambridge Housing Authority Flyer
Cambridge Learning Center
CRLS Youth Employment Center
Current student (Share name in Other field)
Friend or Relative
Just-A-Start Housing Flyer
Past student (Share name in Other field)
School or Other program staff
Training or Job Fair
Word of mouth
Hold control and click to select multiple items.
If Other, please explain or share the name of the person who referred you:
Lead Record Type (
Education Prospective Student)
Lead Status (maaped to Status SF)