Innovation Tech Academy

Registration Form

Please complete the information below to register for a memebrship.

Once completed, you will receive an email with additional details and student login information. We look forward to contacting you with additional details.

Thank you for considering Innovation Tech Academy for your educational experience!

Note: Up to three (3) students can be registered through this form.

Please complete all of the following information:

Contact Information:

First Name: Middle Name: Last Name:

Home Address:


City:	State:	Zip Code:

Telephone #:
Cell #:

E-Mail:

Student Information:

Full Name Student #1	Gender	Age	Grade Level

Please select below which courses to register this student. (Check all that apply)
Free Membership - $0

Full Name Student #2	Gender	Age	Grade Level

Please select below which courses to register this student. (Check all that apply)
Free Membership - $0

Full Name Student #3	Gender	Age	Grade Level

Please select below which courses to register this student. (Check all that apply)
Free Membership - $0

Entry Discount Code:

NON-DISCRIMINATION POLICY

Innovation Tech Academy Corporation admits students of any race, color, national and ethnic origin, gender, disability or sexual orientation to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin, gender, disability or sexual orientation in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs.

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