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Kingsland University Student Agreement (DEV)
First Name
Middle Name
Last Name
Date of Birth
Phone Number
Highest Level of Education
Currently in High School
High school
Currently in GED program
General Education Development (GED)
Some College
Associates Degree
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Program of Enrollment
CYBERSECURITY PROGRAM
FULL STACK DEVELOPER PROGRAM
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Virgin Islands, U.S.
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Demographic Information
With which racial background(s) do you identify? (check all that apply)
Asian
Black
Latino
Native American
Pacific Islander
Caucasian
Prefer not to answer
Self identify:
Where do you identify on the gender spectrum? (check all that apply)
Woman
Man
Prefer not to answer
Self identify:
Employer Name
Job Title
Employment Status
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Full-time Student
Working Full-time
Working Part-time
On Disability
Retired
Unemployed
Other
Employer Industry
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Not Applicable
Accounting
Airlines / Aviation
Alternative Dispute Resolution
Alternative Medicine
Animation
Apparel & Fashion
Architecture & Planning
Arts & Crafts
Automotive
Aviation & Aerospace
Banking
Biotechnology
Broadcast Media
Building Materials
Business Supplies & Equipment
Capital Markets
Chemicals
Civic & Social Organization
Civil Engineering
Commercial Real Estate
Computer & Network Security
Computer Games
Computer Hardware
Computer Networking
Computer Software
Construction
Consumer Electronics
Consumer Goods
Consumer Services
Cosmetics
Dairy
Defense & Space
Design
E-Learning
Education Management
Electrical / Electronic Manufacturing
Entertainment
Environmental Services
Events Services
Executive Office
Facilities Services
Farming
Financial Services
Fine Art
Fishery
Food & Beverages
Food Production
Fund-Raising
Furniture
Gambling & Casinos
Glass, Ceramics @ Concrete
Government Administration
Government Relations
Graphic Design
Health, Wellness & Fitness
Higher Education
Hospital & Health Care
Hospitality
Human Resources
Import & Export
Individual & Family Services
Industrial Automation
Information Services
Information Technology & Services
Insurance
International Affairs
International Trade & Development
Internet
Investment Banking
Investment Management
Judiciary
Law Enforcement
Law Practice
Legal Services
Legislative Office
Leisure, Travel & Tourism
Libraries
Logistics & Supply Chain
Luxury Goods & Jewelry
Machinery
Management Consulting
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Marketing & Advertising
Market Research
Mechanical or Industrial Engineering
Media Production
Medical Devices
Medical Practice
Mental Health Care
Military
Mining And Metals
Motion Pictures And Film
Museums And Institutions
Music
Nanotechnology
Newspapers
Non-Profit Organization Management
Not applicable
Oil & Energy
Online Media
Others
Outsourcing / Offshoring
Package / Freight Delivery
Packaging & Containers
Paper & Forest Products
Performing Arts
Pharmaceuticals
Philanthropy
Photography
Plastics
Political Organization
Primary / Secondary Education
Printing
Professional Training & Coaching
Program Development
Public Policy
Public Relations & Communications
Public Safety
Publishing
Railroad Manufacture
Ranching
Real Estate
Recreational Facilities & Services
Religious Institutions
Renewables & Environment
Research
Restaurants
Retail
Security & Investigations
Semiconductors
Shipbuilding
Sporting Goods
Sports
Staffing & Recruiting
Supermarkets
Telecommunications
Textiles
Think Tanks
Tobacco
Translation & Localization
Transportation / Trucking / Railroad
Utilities
Venture Capital & Private Equity
Veterinary
Warehousing
Wholesale
Wine & Spirits
Wireless
Writing & Editing
How many years of developer experience do you have?
Select
No Experience
Less Than 3 Years
3 to 5 Years
6 to 10 Years
More than 10 Years
I have some knowledge in Object Oriented Programming
Select
Yes
No
I have some knowledge/experience in the following programming languages:
Java
Javascript
Python
C#
C++
Others
No Programming Experience
Preferred Name on Certificate
Certificate First Name
Certificate Middle Name
Certificate Last Name
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