Please Wait...

Epic Bianca Form 2 -Form Fill

Q1

First Name

Full Name*

Q2

Last Name

Full Name*

Q3

ETA ID:*

Q4

E-mail*

Q5

Which payment option does your contract state:*

Q6

Please list the details of your payments/ deposits from records in your ETA Debit Account: *

Q7

In your Student Agreement, find "Specials/ Discounts Details". What do the notes say?*

Q8

In your Student Agreement, find "Payment Schedule & Notes". What do the notes say?*

Q9

Month

What was YOUR class start date?*

Q10

Day

What was YOUR class start date?*

Q11

Year

What was YOUR class start date?*

Q12

If your payment option was "Paid in Full" was the total noted on your Student Agreement in the "Estimated Tuition Costs" box paid within 5 days of the dates listed as "Class Start Date"?*

Q13

If your payment option was "Installments" were all 3 of your installments recieved by the dates and in the total amounts listed on your Student Agreement in the "Payment Schedule & Notes"?*

Q14

Please provide full details as to what your questions or concerns. *