Class of 2023: Student Information FormClass of 2023: Student Information FormIn order to confirm your tuition cycle preference for next year, please fill out this form as soon as possible. It is a great help to our administrative team in the re-enrollment process for Year 2. Thank you in advance! Student Information First Name * Last Name * Email * Which ESM Campus do you attend? * Main Campus - Brighton Online Campus Akron Augusta Cincinnati DC Doylestown Green Bay Indianapolis Lexington Los Angeles New Jersey Omaha Palm Beach SeattleYear 2 Student InformationWhat tuition cycle would you like to follow for Year 2? * Quarterly ($250 USD) Annual ($900 USD) I am not continuing onto Year 2Do You Need to Transfer Campuses? * No YesIf yes, please fill out the Student Transfer Request below: Name * Name First First Last Last Email * Phone * Campus * Student Information First Name * Last Name * Email * What year are you in the program? * Year 1 Year 2What tuition schedule did you select? * Annual QuarterlyCurrent Campus InformationWhat campus do you currently attend * Main Campus - Brighton, MI Online Campus Akron, OH Augusta, GA Brisbane, Australia Cincinnati, OH Doylestown, PA Green Bay, WS Indianapolis, IN Kingston, Canada Lexington, KY Los Angeles, CA New Jersey Omaha, NE Ottawa, Canada Palm Beach, FL Seattle, WA Washington, DCWho is your current facilitator? * V. Obafunwa M. Neely T. Piotrzkowski K. Hammell J. Wenzel P. McGrath Dcn. R. Feldkamp S. Samol K. Bailey M. Hasso M. GonyeauTransfer Information**If you are an online student requesting a change to your class time / day, please select Online Campus**Which campus would you like to transfer to? * Main Campus - Brighton, MI Online Campus Akron, OH Augusta, GA Brisbane, Australia Cincinnati, OH Doylestown, PA Green Bay, WS Indianapolis, IN Kingston, Canada Lexington, KY Los Angeles, CA New Jersey Omaha, NE Ottawa, Canada Palm Beach, FL Seattle, WA Washington, DCWho is your current facilitator? * Current On-Site Student, I do not have one V. Obafunwa M. Neely T. Piotrzkowski K. Hammell J. Wenzel P. McGrath Dcn. R. Feldkamp S. Samol K. Bailey M. Hasso M. GonyeauWhat day / time would you like to be transferred into? * Tuesday, 1pm (ET) Tuesday, 7pm (ET) Wednesday, 1pm (ET) Wednesday, 7pm (ET) Thursday, 1pm (ET) Thursday, 7pm (ET) Thursday, 9pm (ET) What email is associated with your zoom account? * Why are you requesting this change? * If you are human, leave this field blank. SubmitΔ
