Apply Now "*" indicates required fields Step 1 of 6 16% Student InformationName* First Last Email* Date of Birth* Student InformationAddress* Apt # City* State*SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip Code* Cell Phone* Level of education at the start of your programLevel of education at the start of your program* High School GED College/Technical Institute High School Name* Graduation Month*SelectJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberGraduation Year* High School City* High School State*SelectAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingName of College GED Month*SelectJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberGED Year* Do you have a copy of High School Diploma or GED Certificate?Do you have a copy of High School Diploma or GED Certificate?* Yes No Name as it appears on High School records* First Last How did you hear about us?How did you hear about us?* Friend Internet Social Media Other Please specify: Select one of the payment optionsPayment Option Selection* Option #1 – $4,300Pay in Full by First Day of Class Pay The Full Tuition Of The Program With One Payment Of$4,300 Select Selected Option #2 – $4,4507 Installment Payments Pay in Full by First Day of Class$2,000 Pay by Each Following Class$350 Select Selected Option #3 – $4,7007 Installment Payments Pay in Full by First Day of Class$1,200 Pay by Each Following Class$500 Select Selected All Information Stated Above is True and CorrectName Date Signature Reset signature Signature locked. Reset to sign again EmailThis field is for validation purposes and should be left unchanged.