Virtual Course Registration Form

Virtual Course Registration Form
What program are you planning to enroll with?

Skills TrainingParalegal Certificate
Student Information
Student Name

First NameLast Name
Age
Date of Birth

MonthDayYear
Date
Gender

MaleFemale
Nationality
Phone Number
Email Address
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Highest Level of Education

High SchoolGEDAssociate DegreeBachelors' DegreeOther
School Name
School Level/Year of Graduation
Occupation
Company Name
Job Position Title
Previous Legal Experience (if any):
Write something about yourself
Skills, Talents, and Hobbies
Why Do You Want to Become a Paralegal?
(250 words minimum)
Why Have You Chosen This Course?
(150 words minimum)
Do you have any special needs or require accommodations?
How did you hear about this course?
What are your expectations and goals regarding this course? What do you hope to achieve by taking this course?
Document Submission
Please upload the following documents:Proof of Education (required)Resume/CV (optional but recommended)Government-Issued Identification (required)Writing Sample (optional)

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Does the student have any disabilities, illness, medical conditions, personal problems, etc. that can affect his/her virtual classes/study?
If you have any awards, recognition, certificates, please share them here:
Name of Reference

3 References
First Name Last Name Email Street Address Address Line 2 City State Zip Area Code Phone Number
First Name Last Name Email Street Address Address Line 2 City State Zip Area Code Phone Number
Relationship to You:
First Name Last Name Email Street Address Address Line 2 City State Zip Area Code Phone Number
Relationship to You:
First Name Last Name Email Street Address Address Line 2 City State Zip Area Code Phone Number
Relationship to You:
I am an adult (18 years above)I am a minor (17 years below)
Parent/Guardian Details
Parent/Guardian Name

First NameLast Name
Phone Number
Relationship
Others
How did you learn about this virtual course?

FacebookTwitterInstagramYouTubeSearch EngineOnline AdsReferralOther
Any additional comments or information you would like to share?
Student Signature

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Date Signed

MonthDayYear
Date
Parent/Guardian Signature

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Date Signed

MonthDayYear
Date
Should be Empty:

Virtual Course Registration Form

Student Information

Document Submission

Name of Reference

Parent/Guardian Details

Others