Create - Women of Color In Technology

Women of Color in Technology Interest Survey

We're glad that you are interested! Complete the form below and we will contact you to discuss your opportunity for enrollment in the program:

First Name

Last Name

Email Address

Education Level

Phone Number

Is this a mobile phone?

Yes

Training

Preferred Training Format

In-Person
Virtual
Hybrid

Preferred Training Location

Urban League of Greater Southwestern Ohio - Avondale
Hamilton County Community Action Agency - Bond Hill
Gaskins Foundation - University of Cincinnati Digital Futures Building
Brighton Center - Newport, KY

Preferred Start Date

Preferred Google Career Certificate Programs

Indicate your preferences by selecting your top two (2) certificate program interests below:

Preferred Program 1

Preferred Program 2

Note:
* Hamilton County only provides these two programs

Needs, Access, & Accommodations

Your successful completion of the Google certificate program is important to us. Please indicate any barriers you may face in pursuing and completing a Google certificate program (Check all that apply):