First name Last name Email address Confirm email address Phone number Student ID, if known Program or classSelect if applicableAcceptance Test Program 3.12.1 Cohort or start dateSelect a Program firstAcceptance Test Cohort 3.12.1 — July 6, 2026

Payer first name Payer last name Payer email Payer phone Relationship to studentSelect relationshipParentSponsorEmployerFamily memberOther

Payment purposeSelect payment purposeApplication FeeEnrollment FeeRegistration FeeTuition DepositTuition PaymentTuition BalancePayment-Plan InstallmentCPR/BLS ClassMed Tech ClassEKG ClassSkills LabPractice or Review SessionMake a Different Payment Amount you would like to pay$ Note (optional)