Student First Name *

Student Last Name *

Student Email *

Student State

Last Four Digits of Students Social Security Number *

Date of Birth *

Class Request: Please List 5 Classes Below

Class 1

Class 2

Class 3

Class 4

Class 5

I understand the class invoice will be emailed to the Student's Email.

Invoice Payment Options:

Option 1: Pay the invoice in full and submit for reimbursement.

Option 2: Submit the invoice to the Education Market Assistant (EMA).

Smarter by 1 Degree will verify receipt of payment and add the classes to the SB1D portal.

Reminder to check the Student's Email for the Invoice & Class Invitation