Registration Details
To be hidden
Banner Class Checkbox
Yes
Payment Method Banner
Banner
Course Amount
Valid Coupon Code Checkbox
Yes
Order Status
Please select...
Draft
Unpaid
Paid
Account: IPEx academic program
Term Record ID
Course Offering Record ID
Application Record Type ID: IPEx
Record ID
Course Name
Start Date
End Date
Meeting Information (This will be sent to you in an email)
Virtual sessions on Mondays, 6:00 PM to 8:00 PM on 9/8, 9/15, 9/22, 9/29, 10/6, 10/13, 10/21, 11/3, 11/10, 11/17, 11/24, 12/1, 12/8. No class Monday 10/27.
Credit Preference
If you have a discount code, please enter that here
Contact Information
First Name
Last Name
Email
Email (It is import these match to ensure accuracy.)
Phone
Emails do not match
Street Address
City
State
Please select...
Alabama
Alaska
Alberta
American Samoa
Arizona
Arkansas
British Columbia
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Foreign Entity/Non-Applicable
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland and Labrador
North Carolina
North Dakota
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Palau
Pennsylvania
Prince Edward Island
Puerto Rico
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territories
Zip code
Date of Birth
Please use format: MM/DD/YYYY
How Did You Hear About Us?
Employer
Type "none" if not currently employed.
High School Information
High School Name
Type your full high school's name, the field will autocomplete.
GED recipients, type "GED".
Select an option below if you cannot find your school listed.
City of High School
Display only - shows location of school if known.
State of High School
Display only - shows location of school if known.
High School ID
I attended a US High School as listed above
I am unable to find my US High School
I attended a High School outside of the US
Provide High School Name, City, and State/Province
High School Name
High School City and State/Province
High School Graduation Year
Payment Method
Credit Card
Invoice
Final Amount:
Record ID
PLEASE don't exit or refresh a
fter hitting "Next". The next page takes a moment to load.
Contact Information