First & Last Name
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Email
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Mobile Phone
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Which Florida county do you live in?
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Alachua
Bradford
Citrus
Columbia
Dixie
Gilchrist
Hernando
Hillsborough
Levy
Manatee
Marion
Pasco
Pinellas
Polk
Sarasota
Union
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Are you currently employed?
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No I was laid off
No, I quit my job
No, I've been out of work for many years
Yes I am currently working but not making enough and need to improve my skills for a better job
Yes I am currently working full time
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If the right program existed for you, when would you ideally want to get started?
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Within the next 30–60 days
In the next 3–6 months
Later this year
I’m not sure yet
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Do you fall under any of these categories?
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Low Income on Food Stamps
Laid Off
Veteran
Youth (Age 16 -24)
Disabled
Other
None
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Do you have reliable access to a computer, high‑speed internet, and a quiet place to work?
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Yes
Not yet
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Which area are you most interested in exploring right now?
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IT Certifications (CompTIA, Cisco, etc.)
Cybersecurity & Information Security
Cloud Computing (AWS, Azure, GCP)
Project Management (PMP, Agile, Scrum)
Office Administration & Professional Support
Not sure yet — I’d like guidance choosing a path
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How would you rate your current computer skills?
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New to computers
Basic use (email, web browsing)
Used before, but rusty
Comfortable with everyday computer use
Strong skills in office or technical tools
Already certified, looking to advance
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When you decide to invest in education or career development, which best describes you?
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I make informed decisions and move forward when it makes sense
I like to review options and plan carefully before committing
I usually need outside approval or funding to move forward
I’m still exploring what’s possible
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How do you usually prefer to pay for professional development or training?
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Monthly payment plans
One-time payments when possible
Employer reimbursement
Grants or workforce funding
I haven’t invested in training before
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What is your highest level of education?
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High school
Trade/training certification
Business license (realtor, cosmetology, etc)
Some college but no degree
Associates degree
Bachelors degree
Master's degree
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