Please complete the form below. After submission, you will receive a temporary password which you can use to log in to the system & take
as many classes as you'd like.
All the fields are required.
I certify that all of the information on this form is true and complete to the best of my knowledge. If asked, I agree to provide substantiation of the information I have given on this form. I agree that the Education Fund may share my name and contact information with my employer and the training institution in order to verify my eligiblity and enrollment status. I undestand that the specific information related to my academic performance will not be shared with my employer. I agree that the Education Fund may contact me via text message or email. Message and data rates may apply.