Utah Tech University Technology Development Series (Learn and Work in Utah 2023/24)

Utah Tech University Technology Development Series (Learn and Work in Utah) Application

Personal Information

First Name

Preferred First Name

Middle Name

Last Name

Birthdate

Mailing Address

Country

Street

City

Region

Postal Code

Email Address

Mobile Number

Are you Hispanic or Latino?

Yes

Residency

Note: Only legal residents of Utah are eligible for this program.

State of Legal Residence

Additional Information

Do you have a high school diploma (or equivalent)?

Yes

Note: You must have a high school diploma (or equivalent) to be eligible for this program.

Are you currently employed?

Yes

Current Employer

Current Job Title

Why are you interested in this program?

Please describe your background and experience (technical and nontechnical).

Please describe:

Are you interested in obtaining an industry certification?

Yes

What certification(s) are you interested in obtaining?

How did you hear about the Learn and Work program?

Participant Expectations

Expectations: By enrolling in this program, you agree to the following expectations:

Weekly Progress: You are expected to maintain steady progress on a weekly basis, dedicating a recommended 5 to 10 hours per week to your coursework and learning activities. If there has been no activity in your account for the past 30 days, there is a possibility of disenrollment from the program.
Communication: In the event of any challenges, difficulties, or concerns, it is important to promptly notify the program coordinator, Mark Adkins, via email at mark.adkins@utahtech.edu. Clear communication ensures that appropriate support and solutions can be provided.
Professional Conduct: All coursework should be approached with a high level of professionalism. Your engagement in the program should reflect a commitment to quality, integrity, and respect for the learning process and fellow participants.

Your adherence to these expectations contributes to a positive and effective learning experience for all involved.

I agree to the expectations if accepted in the program.

I agree

I disagree

Additional Comments

Certification

I hereby affirm that all the information provided in this application is true, accurate, and complete to the best of my knowledge.

In place of your signature, please type your full legal name as a digital signature.