E-Cornell Program - Application form

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IMPORTANT:

You should have completed all the program by March 31th, 2024! After that date, the program will be closed and participants who did not finish all the classes will not be eligible to the e-Cornell Certificate.

Please fill in this application form. The criteria to apply are as follows:

Be over 18 years of age
Have access to an internet connection and a connected device
Be of Ukrainian nationality and live in Ukraine, or have left Ukraine after 24 February 2022 and be able to provide proof of refugee status on request.

Once your application is validated, you will receive an email with a link to connect to the E-Cornell platform.

Email *

First Name *

Last Name *

E-mail address *

Phone number *

Are you over 18? *

Yes

Do you have a stable internet connection and a connected device?
*

Yes

In which country do you currently live? *

If you are outside Ukraine, please certify on your honour that you arrived there after 24 February 2022 and that you have refugee status in the country where you live. *

I certify on my honour that I left Ukraine after 24 February 2022 and that I have refugee status in the country where I am currently living.

I live in Ukraine

Through which organization did you learn about our program (NGO, word of mouth, social networks, etc.)? If it is an NGO or organization, please indicate its name. *

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