Reactivate or Change Programs

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FULL NAME: ________________________________________

STUDENT ID # __________________________________

DATE ENROLLED: ______________________________

DATE FIRST ATTENDED: ________________________

CURRENT MAJOR: _________________________

NEW MAJOR: _____________________________

 

ASSIGNED INSTRUCTOR: ________________________________________

Please Circle Below That Which Applies to You:

I am picking up where I left off in my program of studies (Reactivation fee $75.00).

I wish to change my Program of Study ($55.00 Change of program fee).

I am submitting a new Payment Plan Agreement.

I have selected Payment Plan A ($75.00 Monthly)

I have selected Payment Plan B ($125.00 Monthly)

I have selected Payment Plan C ($225.00 Monthly)

I wish to reactivate my student status from inactive to active ($75.00).

 

My email, mailing address, telephone numbers, and other contact information have been updated with the school. I am affirming my reactivation by attaching my signature below and I am in good standing with the school or I am changing my program of study to a different discipline.

STUDENT SIGNATURE ___________________________

DATE _________________

 

*You will be contacted by your assigned instructor soon with further instructions. *Print out this page, complete the form and mail it to the school.