Nova Academy

Official Course Registration & Enrollment Form

1 Student Identity

First Name *

Last Name *

Preferred Name / Alias

Date of Birth *

Gender Identity *

Student ID (If returning)

2 Contact Information

Email Address *

Primary Phone *

Street Address *

City *

State / Province *

Zip / Postal Code *

Country *

3 Course Selection

Department / School *

Term / Semester *

Primary Course Choice *

Secondary / Backup Course

Preferred Learning Modality *

On-Campus

100% Online

Hybrid

4 Background & Support

Highest Education Completed *

Current Employment Status

Special Accommodations Request

Please describe any accessibility needs or learning accommodations required.

Dietary Restrictions (For campus events/catering) *

Vegetarian Vegan Gluten-Free None

5 Emergency & Agreements

Emergency Contact Name *

Emergency Contact Phone *

Code of Conduct Agreement *I agree to abide by the Nova Academy Code of Conduct, including academic integrity and anti-harassment policies.

Tuition & Refund Policy *I acknowledge that I have read and understand the financial obligations, payment deadlines, and the academy's refund policy.