Form

Enrollment Form and Law Firm Billing
Contact Information
Full Name*
First Name Last Name

Address*

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number*
- Area Code Phone Number
E-mail*
School and Graduation
Law School*
Graduation Yr.*
Month*

May December
Are you an LL.M. Student?

Yes
Bar Exam
I will take the Bar Exam in the following State:*
Intended Bar Exam Yr.*
Month*

February July
Course
I wish to enroll in the following course:*
I wish to take my course via:*
Please fill in class location(s) and dates. If you selected the Lectures-On-Demand or Live Virtual Classroom options you do not need to fill in a location.

(Call us at 1-800-523-0777 with any questions on dates and locations)
MBE Foundation Course
City 1
State 1
Dates 1
General Bar Review
City 2
State 2
Dates 2
MBE Final Review Course
City 3
State 3
Dates 3
Law Firm
Law Firm Name*
Law Firm Location / Address*
Law Firm Contact
Promotional Code
Student Representative
Enrollment
I acknowledge that I am enrolling with Kaplan PMBR for the sole purpose of my bar preparation and not at the direction of, or for the benefit of, a Kaplan PMBR competitor. I have read, and I understand and agree to, the terms of this agreement. ***

Yes
Please bill my law firm. I confirm that my firm accepts direct billing for the courses that I have selected, but not supplied payment for. I understand that in the event my firm does not pay, I am responsible for payment. (Please Note - we must have complete information about your law firm as indicated above.)*

Yes
** All course materials that you receive during your enrollment are protected by Federal Copyright law and are meant for your personal use only. By signing this agreement, you agree not to reproduce, redistribute, share, sell, auction, or give away any such materials either during or after your enrollment. Violation of this agreement is harmful to Kaplan PMBR and may subject you to civil penalties and/or criminal prosecution. Your enrollment cannot be shared, resold, auctioned, or transferred to another person in any manner. Enrolled students agree to complete payment of tuition prior to instruction. Students who pay by credit or charge card acknowledge receipt of course materials and agree to all tuition payment obligations. All payments are non-refundable after receipt of home study materials. In states that require a different refund calculation, that state’s policy will be applied. No refunds for CDs or MP3s after purchase. In the event tuition is paid by a third party, any refund will be paid to the third party.
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Enrollment Form and Law Firm Billing

Contact Information

School and Graduation

Bar Exam

Course

Law Firm

Enrollment