Adult Fall 2024- Registration
First Name
Last Name
Email
Phone Number
Address
Address Line 1
City
State
Zip Code
What best describes you?
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Self-Pay Student
Saddleback Community College Student
CyberForward Approved Scholarship
Which payment option will you be selecting? First payment needs to be made before first day of class for registration to be confirmed.
Pay in full upon registration ($2,495)
Two payments ($1,247.50 each payment)
Please indicate what your major is. For high school students, please indicate what pathway you are in (i.e. Business, Computer Information Management, etc.) if applicable.
What is your student ID number?
I understand that my registration is pending due to limited seating and is on a first-come, first-served basis
Yes, I understand.
No, I do not understand.
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Student 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:
Full-time
Part-time
Self-employed
Prefer not to answer
Other
How many hours do you work per week?
Do you have any Cyber Security experience?
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Yes
No
Some
Have you attended any other Cyber Security training?
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Yes
No
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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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