CSI-Forge Student Registration Form

CSI-Forge Student Registration Form

Register for IT courses and help us understand your background, experience, and goals.
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Gender
Ethnicity
Age Range
What is your highest level of education completed?
Do you currently attend another institution?
If yes, which institute do or currently attend?
Have you completed any previous IT or cybersecurity courses?
If yes, where & what courses?
Have you earned any IT certifications (e.g., CompTIA, EC-Council, Cisco, & ISACA.)?
Please list any certifications you have earned:
Upload your awarded certifications

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How would you rate your computer skills?
Do you have continuous access to a computer with internet connection?
What types of computer systems do you use regularly?
What operating system do you primarily use?
Have you built or configured a computer before?
Are you familiar with basic networking concepts (e.g., IP addresses, Routers, TCP/IP Model, LAN/WAN, & Firewalls)?
Have you ever worked in IT or cybersecurity-related position?
If yes, please indicate your current or most recent position.
What specific areas of cybersecurity interest you the most?
What specific areas of AI interest you the most?
Have you participated in any cybersecurity competitions (e.g., CTFs, CyberPatriot, HackTheBox)?
If yes, which ones?
Do you currently use any cybersecurity practice environment (home lab, virtual machines, online labs, & Sandbox etc.)?
If yes, please describe the tools and what your home lab set up is?
What are you hoping to gain from these classes?
What are your short-term and long-term career goals in IT or cybersecurity?
What certifications or roles are you aiming to pursue after this program?
What times of day are you generally available for classes or labs?
Are you interested in mentorship, internships, or job placement assistance?
How did you hear about this program?
Which event or source are you coming from?
Do you require any accommodations or learning support?
Student Signature
Date

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Date
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