Arkansas HVACr Academy Program Application

460 W. Randall Wobbe Lane, Suite B, Springdale AR. 72764
Arkansas HVACr Academy Program Application

Please complete the application below. A non-refundable $450 deposit is required to reserve your seat and will be applied toward tuition.
Applicant Information
Full Name

First NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
T-Shirt Size
High School Graduation Date

MonthDayYear
Date
Birthdate

MonthDayYear
Date
Do You Speak English?
What Other Language(s) Do You Speak?
Any HVACr Experience?
Current Employer / HVAC Company
Preferred Class Schedule
Emergency Contact Information
Emergency Contact Name

First NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Applicant
Minor Applicant Information
Are You Under 18 Years of Age?
Parent/Guardian Full Name
Parent/Guardian Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Choose How You Pay (when class starts)
Which payment option do you want to use? *
Questions (Use This Space)
Use this space for any questions you might have.
Seat Reservation Deposit
Seats fill up quick. In order to reserve your spot this fall, please provide a $450 deposit. This will secure your spot today! Questions & Additional Help Call Eric, program director at 479-957-1215.
Square Deposit Authorization

Non-Refundable Seat Reservation Deposit

$450.00

Total