X_NBARP GRANT VERIFICATION

You have received a grant from the National Board of Addiction-Recovery Professionals.
Complete the following form to confirm and activate your grant:

STUDENT INFORMATION

* Indicates required field

Student Name *

First

Last

Student Email *

Student Cell Phone *

Student Zip Code *

EMERGENCY CONTACT INFORMATION

Name *

First

Last

Phone *

Relationship to Student *

I, STUDENT, affirm the following: *

I am at least 18 years old. I am legally authorized to work in the United States. I have never been convicted of any violent felonies. I have a computer or "smart" device on which to attend live, online classes. I agree to all ARCS Terms and Conditions: Read them at http://www.arcstofreedom.com/arcs-tc.html I understand that as an NBARP Grant Recipient, I will pay 10% of my weekly CARC Certification tuition (15.00) and the National Board of Addiction Recovery Professionals pays 90% of my weekly tuition (135.00). I understand that I must attend live, online class for a minimum of 30 minutes weekly, to retain my grant.

CONFIRM

​STUDENT INFORMATION

​EMERGENCY CONTACT INFORMATION

STUDENT INFORMATION

EMERGENCY CONTACT INFORMATION