Student Interest Form

Interested in learning more about attending SIATech or MYcroSchool? Let us know by completing the form below. This does not put you on a waiting list nor secure enrollment. It is simply a request for information.

Full Name (Student)*
First Last
Email Address (Best email for info on school)*
Mobile Number (Best number for info on school)*
What is the student's age?*
Student's Date of Birth*
MM slash DD slash YYYY
Current Address*
Street Address City State / Province / Region ZIP / Postal Code Country
What state are you interested in attending?*
What region in California are you interested in attending?*
Select a campus in Imperial Valley*
Select a campus in Inland Empire/Riverside*
Select a campus in Los Angeles*
Select a campus in Northern California*
Select a campus in San Diego (North County is in Oceanside, and South Bay is in Chula Vista)*
How did you hear about us?*
Do you already have your transcripts from previous high schools?*
- Yes
- No
- Not Sure
Do you have a copy of your IEP or 504? (if you have one)*
- Yes
- No
- Not sure, or this doesn't apply to me
Questions or Comments?

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Student Interest Form

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