Retail Management Program Applicant Interest Form

First Name  

Last Name  

Email  

Address  

City  

State  

Zip Code  

Phone Number  

Date of Birth  

I am interested in  

12-Week Online Traditional Track, Certificate12-Week Online Traditional Track, AAS Degree

Are you a CNM student?  

Yes No

CNM ID Number

Are you currently employed in the retail industry?  

Yes No

Company Name  

Store Number  

Job Title  

Human Resources Contact  

Human Resources Phone Number  

Spam Check