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
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?*
YesNo
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)?*
YesNo
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?*
YesNo
If yes, which ones?
YesNo
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?*
Do you require any accommodations or learning support?*
Student Signature*

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