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Birthday
Month
Day
Year
Which level are you applying for?
Which class are you applying for?
Which class session works best for you?
Which payment plan are you considering?
What are your primary goals for joining Ebony J Media Coin Academy?
How did you hear about Ebony J Media Academy?
Are you able to commit to weekly live sessions?
Yes
No
Are you able to dedicate 4-6 hours/ week for independent project work?
Yes
No
Are you able to attend quarterly Media Mixer Event or capstone showcase?
Yes
No
Do you have access to the following (check all that apply)

Rate your current knowledge and experience level in the following areas (1 = Low, 5 = High):

What's your comfort level with technology?
Beginner
Intermediate
Advanced
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