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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:*
Paid in Full
Installment
Pay as FLy
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"?*
Yes
No
Not Applicable, because I did not use "Paid in Full"
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"?*
Yes
No
Not Applicable, because I did not use "Installments"
Q14
Please provide full details as to what your questions or concerns. *
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