Contact Information
Please enter the contact info for who will be paying the bill. If the student is a minor, please enter the guardian's contact info.

First Name(s) *
Last Name *
Address 1 *
Address 2
City *
State *
ZIP *
*
Email/Username *(for example: [email protected])
Additional Emails(for example: [email protected], [email protected])

Password
Please make a note of your email-address/username above and the password you enter below. They will be used to log into your account in the future.

Password *
Re-type Password *

How did you hear about Arya? *
More Details

Emergency Contact Information
Who should we contact, other than the contact listed above, in case of an emergency?

Emergency Contact Name(s)
Emergency Contact Phone(s)
* = Required Fields
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