Adult Class Registration- Spring 2024
First Name
Last Name
Email
Phone Number
Address
Address Line 1
Address Line 2
City
State
Zip Code
Country
Select Country
Afghanistan
Aland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belau
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo (Brazzaville)
Congo (Kinshasa)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Ivory Coast
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao S.A.R., China
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palestinian Territory
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
São Tomé and Príncipe
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin (Dutch part)
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia/Sandwich Islands
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom (UK)
United States (US)
United States (US) Minor Outlying Islands
United States (US) Virgin Islands
Uruguay
Uzbekistan
Vanuatu
Vatican
Venezuela
Vietnam
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Are you an UpSkill OC Participant ?
- Select -
Yes
No
Which payment option will you be selecting? First payment needs to be made before first day of class for registration to be confirmed.
- Select -
Pay in full upon registration ($2,495)
Two payments ($1,247.50 each payment)
Approved Scholarship
Demographic Information
The following questions will not determine your status in the class.
Age:
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Under 20
20-30
31-40
41-50
51+
Prefer not to answer
Gender:
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Male
Female
Other
Prefer not to answer
What is your ethnic background?
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Black or African American
White or Caucasian
Asian or Asian American
Hispanic or Latino
Pacific Islander
Native American
Bi-Racial or Multi-Racial
Prefer not to answer
Are you a Veteran?
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Yes
No
What is your highest level of education?
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High School Diploma/ GED
Some College
Associates Degree
Bachelors Degree
Masters Degree
Other
Prefer not to answer
Are you currently attending school?
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Yes
No
Current Employment Status:
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Full-time
Part-time
Unemployed
Other
Prefer not to answer
If you are currently working, how many hours do you work per week?
Do you have any Cyber Security experience?
- Select -
Yes
No
Some
Have you attended any other Cyber Security training?
- Select -
Yes
No
Needs and Commitments
For online learning, you will need access to a computer/laptop and WiFi for the duration of the class. Please respond by check the box that best describes your situation.
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I have access to computer/laptop and WiFi
I do NOT have access to computer/laptop or WiFi
Students are required to attend and participate in all live sessions for the duration of the CyberForward class. CyberForward reserves the right to dismiss students from the program due to excessive absence, excessive tardiness, and other misbehavior. Upon completing this form and your payment, you will be fully registered for the class.
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I understand and agree
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