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CGTC Academy Dual Achievement Program (DAP) Information Request Form

Student Information

What is your name? *This question is required.

Last
First

What is your date of birth? *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

What is your phone number? *This question is required.

What is your parent/ guardian's phone number? *This question is required.

Can we text you? *This question is required.

What is your email address? *This question is required. This question requires a valid email address.

How many years have you been living in Georgia? *This question is required. This question requires a valid number format.

Are you currently attending High School? *This question is required.

What is your current high school or the last high school you attended?

Have you earned 6 or more high school credits? *This question is required.

Which campus are you closest to?

What Technical Program of Study are you Interested in? *This question is required. (Our Program of Study list can be found on our website here: https://www.centralgatech.edu/programs-of-study)

Do you have a smart phone? *This question is required.