The ReFresh Institute, Inc. Enrollment Form

THE REFRESH INSTITUTE ELECTRONIC ENROLLMENT FORM

Registration Fee Submission

General Student Information

* Indicates required field

Name *

First

Last

Parent/ Guardian Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Date of Birth (mm/dd/yyyy) *

Gender *

Are you an active military? *

Which scholastic year are you enrolling for? *

Which academy/courses are you enrolling in? *

CReative Arts Academy

COMPLETE THIS SECTION ONLY IF YOU ARE ENROLLING IN THE CREATIVE ARTS ACADEMY OR BOTH ACADEMIES.

Which certification program are you enrolling in for the scholastic year above? *

Level of Study *

Do you require any special accommodations? *

If you require special accommodations, please specify the services/accommodations needed. *

Worship Arts Academy

COMPLETE THIS SECTION ONLY IF YOU ARE ENROLLING IN THE WORSHIP ARTS ACADEMY OR BOTH ACADEMIES.

Which certification program are you enrolling in? *

Do you require any special accommodations? *

If you require accommodations, please specify the service/accommodations needed. *

Specialized Departmental Courses

Which course are you enrolling in? *

Do you require any special accommodations? *

If you require accommodations, please specify the service/accommodations needed. *

Enrollment Essay

In 250 or more, please tell us why you believe enrolling in this institution will impact your life as you matriculate through your journey with God? *

Enrollment Acknowledgements

I confirm that all the information provided above is the best and accurate information that I presently have. I understand that in the event, any of this information changes, I will submit an electronic notification to the admissions office of The ReFresh Institute,Inc. regarding my modifications. *

I confirm I do not confirm

I understand that the submission of this application begins my enrollment for The ReFresh Institute, Inc. I understand that all tuition, fees, additional supplies for the certification programs will be confirmed after thoroughly review of my enrollment form for the academy selected above. *

I understand I do not understand

By submitting this application, I commit to fulfilling my responsibilities as a scholar of The ReFresh Institute, Inc. *

I commit I do not commit

As a parent/guardian of a minor, I understand and agree to all the terms stated above. *

I understand & agree

I agree to receiving marketing and promotional materials

Submit to Complete Registration