First & Last Name
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Email
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Mobile Phone
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Which county in FL do you live in?
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Hillsborough
Pasco
Hernando
Pinellas
Polk
Sarasota
Manatee
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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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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
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Do you have your DD214?
Yes
No
Working on it now
I have access to computer equipment, high-speed internet, and a quiet place to work.
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Yes
No
Do you have your COE? (Certificate of Eligibility)
Yes
No
Working on it
Is there anything blocking you from starting your course in the next 30 days?
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Which program are you interested in?
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Business Administration
IT Certifications
Cybersecurity
Cloud / AWS
Data Analyst
Not sure - help!
How would you rate your current computer skills? Select one.
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I don’t know the difference between a mouse and keyboard.
I can navigate to email and online searching.
I’ve used a computer in the past but it’s been a while.
I’m totally comfortable using basic computer navigation.
I have advanced skills in some office applications and/or programming.
I've got some certifications and need more
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