Interest Form

Thank you for your interest in the Brooklyn Networks Cable Training Program. Please complete the following form before attending one of Brooklyn Networks' information sessions.

Please contact Anastasia Counts, Program Manager, at bn@bwiny.org or 718-237-2017 x140 with any questions

First Name

Last Name

Preferred Name

Date of Birth (MM/DD/YYYY)

Cell Phone

Zip Code

How did you hear about Brooklyn Networks?

How did you hear about Brooklyn Networks? Please specify

What technology do you have access to?

ComputerTabletSmartphoneNone of the above

Which info session would you like to attend? (please choose only one info session option to attend)