Online Application

Personal Information

• Suffix: Select Mr. Mrs. Ms. Miss
  *First Name:
  Middle Name:
  *Last Name:
  *Date of Birth: Month 1 2 3 4 5 6 7 8 9 10 11 12 / Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Year 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 1919 1918 1917 1916 1915 1914 1913 1912 1911 1910
• *Address:
  Apt No.:
  *City:
  *State:
  *ZIP:

Contact Information

• Home Phone:
  Work Phone:
• Cell Phone:
  *Email Address:

High School or GED

• GED Information
  
  State where GED issued:
  Date:
• OR
• High School Information
  
  High School Name:
  City and State:
  Date Graduated:

Additional Education

• School Attended:
  Course of Study:
• Graduated: Yes No
  Year:

• School Attended:
  Course of Study:
• Graduated: Yes No
  Year:

• School Attended:
  Course of Study:
• Graduated: Yes No
  Year:

• School Attended:
  Course of Study:
• Graduated: Yes No
  Year:

School Location and Program Information *Location: Lancaster York

• ASB Degree
  
  Business Administration: Management Trainee
  
  Computerized Office Management
  Administrative Assistant Option
  Web Focus Option
  System Specialist Option
  
  Computerized Accounting Management
  
  Medical Administrative Assistant
  Clinical Assistant
  Health Insurance/Billing Option
  Transcript Option
  
  Legal Administrative Assistant
  
• Diploma
  
  Clerical Accounting Specialist
  Legal Office Specialist
  Medical Office Specialist
  Office Associate
  

I understand that all Consolidated School of Business literature is intended for informational purposes, is subject to change without notice, and is available upon request from our Admissions Office or online at www.CSB.edu.

By checking this box, I am verifying that the information supplied on this application form is correct.