Transformation Academy- Enrollment Form

Name

First Last

Email

Phone

Date of Birth

MM/dd/yyyy

Age

Ethnicity *

Address

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

Previous School Attended

Previous School City/State

Last School Grade Completed

Emergency Contact Name

First Last

Promo Code

Get Started Session *

Transformation Academy is a partner with Emma Lee Broady Academy. The Broady Academy diploma will be issued to all Transformation Academy graduates. The regionally accredited high school diploma will enable graduates to use their diploma for community college, career/trade school, 4 year college, and/or the military.

I agree

Terms and Conditions *

By checking the box below, I am confirming that I have verified with my school, employer, or other institution that they accept the E.L. Broady Academy diploma and that there are no refunds after 5 working days

I agree

Student Digital Signature *

Date Signed *

MM/dd/yyyy

ENROLL - Transformation Academy

Life Resume Guide

Error Occurred

Link to resume this form later:

Turn on the camera permission in your browser to continue further

1		2
Page 1		Page 2