Applicant Information Enter your name exactly as it appears on your Passport. First Name * Last Name * Email Address * Street Address 1 * Street Address 2 Phone Number * City * State * AlabamaAlaska ArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhodeIslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Country of Citizenship * AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamas, TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia & HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic Of TheCosta RicaCôte D'ivoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFederated States Of MicronesiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorth MacedoniaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRepublic Of The CongoRomaniaRussiaRwandaSaint Kitts & NevisSaint LuciaSaint Vincent & The GrenadinesSamoaSan MarinoSão Tomé & PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe Have you been notified of your admission to CBT Technology Institute? YesNo Gender: MaleFemale What level of education will you pursue? Associate in Electrical program Associate in HVAC program Associate in Information Technology program Dependents Complete the following information about your spouse and/ or child (children) Only if they will come with you to the U.S. Name (family first) Date of Birth Relationship to You Country of Birth AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamas, TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia & HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic Of TheCosta RicaCôte D'ivoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFederated States Of MicronesiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorth MacedoniaNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRepublic Of The CongoRomaniaRussiaRwandaSaint Kitts & NevisSaint LuciaSaint Vincent & The GrenadinesSamoaSan MarinoSão Tomé & PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwedenSwitzerlandSyriaTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe If you are in the usa You can attend regardless of your status. F-1 What is your SEVIS ID Number? * Another Status, Which one? * Will you be traveling outside the country before the program start date? * YesNo If you are in the usa You can attend regardless of your status. How would you like us to deliver your Form I-20? * Mail to International AddressMail to U.S. AddressHold for Pick Up What time is good for us to contact you?* 9-10 AM10-11 AM11-12 PM12-1 PM1-2 PM2-3 PM3-4 PM4-5 PM5-6 PM6-7 PM7-8 PM Submit Disclaimer: By submitting this form, I agree that CBT Technology Institute may contact me via phone, email or text, including with automated technology, regarding educational services at the phone number I have provided, including any wireless number. My information will be used exclusively by CBT Technology Institute.
First Name * Last Name * Phone Number Email Address * Campus * Select CampusFlagler Main CampusHialeah CampusCutler Bay Campus Program * Select Program Submit Disclaimer: By submitting this form, I agree that CBT Technology Institute may contact me via phone, email or text, including with automated technology, regarding educational services at the phone number I have provided, including any wireless number. My information will be used exclusively by CBT Technology Institute.
