Application Form- Advanced Cybersecurity Leaders Program

Advanced Cybersecurity Leaders Program

Nomination Application Form
Full Name*

First NameMiddle NameLast Name
Civil ID Number*
Enter Your 12 Digits Civil Id Number
Date Of Birth*

DayMonthYear
Date
Email*
example@example.com
Mobile Number*
Please enter a valid phone number.Format: 0000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Educational Qualification

Rows	Educational Institution & Country	Education Qualification	From Date	To Date
*
*
*
*

Cybersecurity Certifications / SANS SEC566 – GCCC/ Other SANS GIAC Certificate/ IT Training / Other Professional Certification (if available)

Rows	Training Name	Professional Certification (if available)	MM/YYYY	CPE Credits
*
*
*

Occupation

If the applicant has work experience, kindly to fill the following tables:

Rows	Information
Current Job Title
Total Years of Experience
Employer Address
Immediate Supervisor
Employer Phone Number

Work Experience (starting with current job)

Rows	Employer	Department	Job Title	From Date	To Date	Job Description
*
*
*
*

Languages

ARABIC*

Rows	Fluent	Average	Poor
Reading
Writing
Conversation

ENGLISH*

Rows	Fluent	Average	Poor
Reading
Writing
Conversation

Objective of Joining the Program *
Enter your text
Penalty Clauses
·       In case of the participant’s withdrawal during the program period (period of 3 months), he/she shall bear the full cost of the program. In case of failure to pass, the participant shall bear the cost of the period spent in the program.

·       The participant shall declare to be obligated by the general rules and regulations at the training and exams venues at KIBS.

·       The participant shall declare to be bound to code of conduct, and to respect his colleagues, members of the training faculty and the program officers.

·       The participant shall abide with daily attendance for all training programs and related exams at their specified times, and not to be absent except due to unforeseen circumstances, while reporting the case to the concerned authority immediately and providing official evidence of the reasons for absence in order to take the necessary actions.
Institute of Banking Studies Rules and Regulations
Consent to Media Usage
Confidentiality and Data Protection
Required Documents
Copy of the accredited university degree or a transcript for the 2025 graduates*

Files Allowed : pdf, jpg, jpeg, png, gif ( Maximum 5mb)
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Copy of the civil ID*

Files Allowed : pdf, jpg, jpeg, png, gif ( Maximum 5mb)
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Passport Copy*

Files Allowed : pdf, jpg, jpeg, png, gif ( Maximum 5mb)
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Recent personal photo*

Files Allowed : pdf, jpg, jpeg, png, gif ( Maximum 5mb)
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SANS SEC566 GCCC certification copy*

Files Allowed : pdf, jpg, jpeg, png, gif ( Maximum 5mb)
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Nomination letter from the employer (for employees)

Files Allowed : pdf, jpg, jpeg, png, gif ( Maximum 5mb)
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Official CPE credits certification or transcript. (Required if the applicant has less than 6 years of work experience)

Files Allowed : pdf, jpg, jpeg, png, gif ( Maximum 5mb)
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A recent nationality certificate from SAHEL (سهل)*

Files Allowed : pdf, jpg, jpeg, png, gif ( Maximum 5mb)
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A completed candidacy application*

Files Allowed : pdf, jpg, jpeg, png, gif ( Maximum 5mb)
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Acknowledgement
I, the undersigned, hereby acknowledge that all the above-mentioned information are true, and I declare my commitment to my full legal liability for its correctness. I acknowledge that I have read the terms of joining the program, and undertake to abide by what was stated in them.

I acknowledge and consent to the terms and conditions outlined above. I grant permission to the Kuwait Institute of Banking Studies and its affiliates to capture and utilize video recordings, audio recordings, and photographs of me for promotional purposes. I am aware and agree that the Institute may use these materials in ways it finds suitable to support its objectives. I release the Institute from any liability related to this usage and agree not to pursue any claims against the Institute or its partners concerning this promotional content.
Acknowledgement Signature Date*

DayMonthYear
Date
Signature*

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Should be Empty:

Advanced Cybersecurity Leaders Program

Educational Qualification

Occupation

Languages

Penalty Clauses

Institute of Banking Studies Rules and Regulations

Consent to Media Usage

Confidentiality and Data Protection

Required Documents

Acknowledgement