Application Form Work In Tech program 2023 - Google Cybersecurity Certificate
Work in Tech Program 2023 powered by Coursera, INCO & KYNA Academy
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We respect your privacy and, in accordance with European data protection regulations, the collected data will be accessed only by persons responsible for the training program.
These data are collected for the sole purpose of measuring the social impact of the Work In Tech program and its efficiency. Your personal data will be deleted at the end of the program.
What is your name? Fill in your first name(s) and surname.
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Fill in your name correctly. This name will show on your official certificate. 
What is your email address?
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Please note that you have to use this email on all the platforms related to the Work In Tech program. 
What is your phone number?
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How old are you ?
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What is your gender identity?
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Which of the following demographic groups applies to you?
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(You can select multiple answers) 
Required
What is your highest completed education?
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What is your current employment status?
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Do you have any experience with online learning?
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I have a laptop/ computer available for the duration of this program.
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Please note that this program is offered online. There are no on-site lessons taking place.
Your time dedication
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Your selected program Google Cybersecurity Certificate includes 155 hours of online learning material. If you dedicate 10-12 hours per week to your online learning, it should take you 3-5 months to complete this program. Kindly note that inactive learners (30 or more days of no study) will be removed from the program.
Do you live in the Netherlands or have a Dutch address?
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We are only accepting candidates who live in the Netherlands or have a Dutch address.
If this is not your case, the Work in Tech program is currently active in many other countries. We suggest that you look for another alternative in your current country of residence.
Your motivation *
In a few words, let us know why you want to join this program and what you wish to achieve. 
Declaration of Intent and Cooperation
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I UNDERSTAND THAT, UPON BEING ACCEPTED TO THIS PROGRAM, 
I WILL FILL IN ALL THE FOLLOW-UP SURVEYS- QUESTIONNAIRES EMAILED TO ME (AN 'ENTRY SURVEY DUE BEFORE THE START OF THE PROGRAM, AND GRADUATION/ EXIT SURVEYS  DUE AFTER THE END OF THE PROGRAM). 
FAILURE TO COMPLY CAN RESULT IN THE TERMINATION OF THIS AGREEMENT.
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