Clone of Product Order Form

Next Course Enrollment (Current Students Only)

Please complete the form below to request enrollment in your next course. Once your request has been received and reviewed, you will receive an email with a payment link for the course fee. Need a little flexibility with payment? You can now choose Affirm at checkout to set up a payment plan and pay over time directly through Affirm. Please note that Affirm is currently the only installment payment option available. Your enrollment will be processed once payment has been completed.
Full Name

First NameLast Name
E-mail
example@example.com
Billing Address (only complete if your address has changed since your last course)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Contact Number
Format: (000) 000-0000.
PHCC Member Company
Has your Employer changed since your last course?
If Yes, Please provide your new Employer Information

Employer Company Name

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Plumbing Apprenticeship (choose your next course)
HVACR Apprenticeship (choose your next course)
Final Exam & Course Completion Acknowledgment I acknowledge that all final exams required to complete a course must be proctored via Zoom. Once I complete the final module of my course, I am responsible for contacting academy@nj-phcc.org to schedule my final exam. I understand that I must have access to a laptop, desktop computer, or iPad with a working camera and internet connection to take my proctored final exam. Final exams are scheduled Monday through Friday between 8:30 a.m. and 4:00 p.m. I understand that the course fee is non-refundable. I have 12 months from my enrollment date to complete the course. If I am unable to complete the course within 12 months, a 6-month extension may be purchased for an additional fee. It is my responsibility to contact the Academy before my course expires if an extension is needed. If my course expires and I do not contact the Academy, the course may be considered abandoned and deleted from the learning system. All completed coursework and progress will be lost. To continue, I will be required to re-enroll and pay the current course fee. I understand that this is a self-paced course. I am responsible for staying on track, completing the required coursework within the allotted time, and communicating with the Academy if I experience any issues or concerns.
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Next Course Enrollment (Current Students Only)