*First Name
*Last Name
*Day Phone
Evening Phone
* State
*High School Grad Year
Yes / No * By checking YES and submitting this form to
STVT, constitutes and confirms your written express consent to be called and/or texted by a
representative from STVT using an automated telephone dialing system at the phone number(s)
you provided on this form, which may include your mobile/cell phone number.
All calls placed to you will be regarding educational services that you are requesting.
You are not required to provide consent to receive information from this school.
Additionally calls may be monitored for quality assurance purposes.