Enrollment Form | Empowered Electrical Education

Please fill out the application below to enroll in our Apprentice Program or register for Continuing Education courses. After clicking Submit, you’ll be taken to PayPal to submit payment. Your application will not be complete until payment has been received. If you have any questions before enrolling, please contact us through this form and we’d be happy to answer any questions.

Name*

First Last

Phone*

Email*

Address*

Please specify below, the address where you would like your books shipped (i.e. home or work address):

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

How did you hear about us?*

Existing or former student
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Website or internet search
Employer

Course Type*

Apprenticeship
Continuing Education

Payment*

Pay Full
Three Installments

Apprenticeship Product - Full Payment -June 22nd, 2023 Course: $3000 Tuition and $325 Course Books

A 2023 NEC Code books is required for this course.*

Full Payment -June 22nd 2023 Course: $3,000 Tuition and $325 Course Books

Apprenticeship Product - Three Installments -June 22nd 2023 Course: $1,000.00 1st Semester Tuition and $325 Course Books

A 2023 NEC Code books is required for this course.*

Three Installments -June 22nd 2023 Course: $1,000.00 1st Semester Tuition and $325 Course Books

Should your books be shipped to the address provided? If not, please specify below, the address where you would like your books shipped (i.e. home or work address):

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Type of Address

Home
Business

Terms & Conditions*

I have read the terms & conditions for enrolling in this class.

Terms & Conditions
Once a student begins a semester there will be no refund available for that semester payment.
Empowered Electrical Education reserves the right to terminate any student from their course for pour attendance, being disrespectful, incomplete assignments (Tests), or any other reason applicable.
Any refund will be made less the transaction fees.
If a semester payment is late or has not been paid then Empowered Electrical Education retains the right to remove the student from their course. Course completion certificates and transcripts will not be available to a student with a(n) outstanding payment(s) balance.

Company Name*

Employer Name*

Employer's Email Address*

Employer's Phone Number*

Who is paying for this course?*

Self Pay
Employer

Would the Employer like to be contacted regarding attendance and test grades?*

Yes
No

Continuing Education Product

Choose Enrollment Options (all which apply)*

We have completed all CE Course offerings for the 2020 renewal cycle

We have completed all CE Course offerings for the 2020 renewal cycle

Would you like to be contacted regarding future classes?*

Yes
No

Which course?*

Total

$0.00

Enroll

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