MPP Student Enrollment & Payment Form

For New & Returning MPP Students

Secure Your Enrollment

STUDENT'S INFORMATION

Student Name*

Student Email Address*

Your Current Grade Level*

6th
7th
8th

Student Photo Submission: Please Upload a Passport Sized Photo of the student applying to the program (taken within the last 3 months)

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Have you been suspended from school for any reason?*

Yes
No

Date of Birth*

Address*

Best Phone Number to Reach You*

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Gender*

Male
Female

Adult T-Shirt Size*

Small
Medium
Large
Extra Large
2XL
3XL

Race/Ethnicity:*

White/Caucasian
Hispanic/Latino
Asian
Black or African American
American Indian
Alaska Native
Middle Eastern
Middle Eastern
Other

Are you a U.S. citizen?*

Yes
No

How did you hear about the MPP Academy?*

Teacher
School
Counselor
Friend
Family Member
My School
MPP Student
MPP Alumni
Online Search
Facebook
My Church
Other

REFERRAL INFORMATION:

Provide the NAME and EMAIL of the person who referred you or assisted you with applying for admission to MPP Academy.

***We would like to send a thank you card to the person who referred you to the MPP Academy.

FULL NAME OF REFERRER:*

REFERRER EMAIL: ***We would like to send a thank you card to the person who referred you to the MPP Academy. **

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