Southern Maryland Engineering Partnership Interest Form
Name
*
First Name
Last Name
Are you a current CSM student?
*
Yes
No
CSM Email Address:
*
Confirmation Email
aasmith@mymail.csmd.edu
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
What type of Engineering are you interested in?
*
Aerospace Engineering
Biomedical Engineering
Chemical Engineering
Civil Engineering
Computer Engineering
Electrical Engineering
Mechanical Engineering
Other
Have you graduated high school?
*
Yes
No
Name of high school?
Current grade:
Submit
Should be Empty: