YOUR INFORMATION

First Name *

Middle Initial

Last Name *

Last 4 Digits of your Social Security # *

Date of Birth * +

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address (Use your personal email address and not your academy issued address.)
CHECK YOUR EMAIL REGULARLY FOR NOTICES. *

T-Shirt Size (S, M, L, XL, 2XL, etc.) *

Please indicate whether you are an engine or deck major. *

Engine

Deck

Have you previously attended the CMES Academy Internship Program? *

Yes

No

If yes, which classes have you completed? Please check all that apply. *