Confirmation - Cybersecurity Workforce Program Re-enrollment Request Form

	Thank you for submitting your application to the Cybersecurity Workforce Program. We will reach out to you soon with the next steps. If you have any questions, contact us at nsacyber@louisville.edu Cybersecurity Workforce Program Re-enrollment Request Form First Name Adam Middle Name Last Name smith Date of Birth 01/01/1988 Email adam.smith0016@gmail.com Confirm Email adam.smith0016@gmail.com Phone Number 856-236-3706 What program are you applying for? Full Program, Security Bundle Would you like to enroll in the Logistics or Healthcare version of the course? Logistics Were/are you a member of the military? No Are you a disabled veteran? No Do you have regular/consistent access to a computer and internet service? Yes Does your computer utilize Windows operating system? Yes Cohorts last 3-6 months from the start date. Are you able to make this time commitment? Yes

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