Congratulations on being accepted into CSMTech Academy!

Please fill out the following form to confirm your spot in CSMTech. 

**Please note that once you hit the "Send Now" button below, you will see a page that confirms that your information has been sent.



Items denoted with a red asterisk * are required.
 * I accept my position into CSMTech!
 


 * Last name of student:
 
 * First name:
 
 * Home address:
 
 * City:
 
 * Zip code:
 
 * Home phone number:
 
 * Parent/Guardian Name(s)
 
 * Parent/Guardian email address:
 
 * Student email address:
 
 * Which district are you from?
 



If other, which district are you from?
 
Any other contact information we might need?