National CyberSecurity Student Association (NCSA) Chapter Request Survey/Application
The National Cybersecurity Student Association is a one-stop-shop to enhance the educational and professional development of cybersecurity students through activities, networking and collaboration. This group supports the cybersecurity educational programs of academic institution, inspires career awareness and encourages creative efforts to increase the number of underrepresented populations in the field. For more Information, please visit http://www.cyberstudents.org/ or contact chapter@cyberstudents.org

Please fill out the following initial application if you are interested in becoming an NCSA Chapter. Please Type NA if information is not available or not applicable.
Which state your University/School is located in? *
Name of your University/School *
University/School type *
Fully online University/School? *
University/School mailing address *
Types of cyber related credentials that are offered by your school? (Select as many) *
Required
Name of Department/College where NCSA will be hosted? *
Host Department/College Website address? *
Do you have an existing Cybersecurity (or related) Student Club? *
Name of the Student Club (Existing or proposed) *
Approximate number of members in the club? *
Student Club Composition (Existing or proposed) *
How often does your club hold or plan to hold meetings/events? *
Existing club website address (if available)
Name of Faculty Advisor(s) *
Faculty Advisor(s) email address *
Faculty Advisor Title *
Student representative name *
Student representative email address *
Chapter Officers positions (pres, vp, treas, sec), names & emails
Is your institution willing to host/sponsor NCSA national events? *
Why are you interested in becoming an NCSA affiliated Chapter? Please provide a brief narrative. *
Identify few benefits that your club would like to see as a result of becoming an NCSA Chapter *
Please suggest one thing that you would like to see being an NCSA Chapter *
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