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Easy Draw Academy

Student Application Form

Empowering Passionate Healthcare Professionals

  1. Personal Information

Birthday
Month
Day
Year
Gender
Male
Female
Other
Prefer not to say

  1. Emergency Contact

  1. Program of Interest

Check all that apply

  1. Education History

Highest Level of Education Completed:
High School Diploma
GED/High School Equivalency
Some College
Associate Degree
Bachelor's Degree or Higher

  1. Employment Information (Optional)

  1. Funding & Payment

Are you seeking tuition assistance through NJ ETPL or other programs?
Yes
No
If NO, how will you be paying?
Payment Plan
Paid in full
Other

  1. Background Information

Have you ever been convicted of a felony?
Yes
No
Do you have any medical conditions that may require accommodations?
Yes
No

  1. Student Acknowledgement

I certify that the information provided on this application is true and accurate to the best of my knowledge. I understand that any false information may be cause for denial of admission or dismissal from Easy Draw Academy.

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Date
Month
Day
Year
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