Fields marked with an * are required.
Program:
Life Skills
Course:
Financial Literacy 101
First Name:
*
Last Name:
*
Date of Birth:
*
Address:
*
City:
*
State:
*
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ZIP:
*
Phone:
*
-
-
Alternate Phone:
-
-
Email:
*
School Address:
School City:
School State:
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
School ZIP:
Expected Start Month:
*
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January
February
March
April
May
June
July
August
September
October
November
December
Select a payment method:
*
Check
:
Make check payable to NECF in the amount of $249 and mail to:
Registrar/Life Skills, NECF, P.O. Box 678423, Dallas, TX 75267-8423
Credit
:
To process a credit card payment, submit this form then call the NECF Bursar at 888-696-6323.
Scholarship
:
If you were given a scholarship packet, enter the code # found on the back of
the Getting Started booklet:
Electronic Signature:
*
By checking this box, I certify that all information I have provided about myself is accurate and that I understand this is a registration form. I also understand that I am financially responsible for the course tuition unless I have indicated a scholarship code.
Additional comments/questions: