Study Grant for ARE Exam Preparation

Applicant Information
Full Name *

First Name Last Name
E-mail *
example@example.com
Phone Number *

Area Code Phone Number
Address *

Street Address

Apt/Suite #

City State

Postal / Zip Code Country
Please list the exams you have taken and indicate if you passed or not:
Does your firm offer support for ARE Exams:

Yes No
Are you part of a study group?

Yes No
Would you be interested in being part of a study group?

Yes (If yes, you may be invited to a study group by the EP Community) No, I prefer to study alone
Please choose your top 3 months below. Of those top 3 only one month will be chosen.
Month 1
Month 2
Month 3

Applicant Information