I4G Coursera Application

Coursera Application

Full Name*
First Last
Gender*
Email Address*
Address*
State Country
Date of Birth
Date Format: MM slash DD slash YYYY
Phone number*
Are you a student?*
Institution*
Employment Status*
Current Job Title*
Industry*
Why do you want to take a course?*
What skills do you want to learn?*
Interested job role*
Are you able to commit 3 - 4 hours every week?*
How did you find out about this opportunity?*