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MPower Online Learning - External Application 2022 (1)

This is the application to submit your interest in MPower Online Learning services. Upon completion of this application, you will be contacted to set up a Zoom interview before enrollment is completed.
MPower Online Learning services does not accept waiver-based funds, all enrollment fees are self-pay only at this time. Are you still interested in these services?(Required)
Applying or enrolling in MPower Online Learning services has no bearing on admission, acceptance or access to any other My Possibilities programs. By submitting this application, you are acknowledging that participation in MPower Online Learning WILL NOT impact any current status held with My Possibilities.(Required)
Applicant Name(Required)
MM slash DD slash YYYY
Applicant's Parent/Guardian's Name(Required)
Parent/Guardian Email Address(Required)
Is the above person the applicant's parent or guardian? Check all that apply.
Parent/Guardian Contact #1 Information - Name(Required)
Parent/Guardian Contact #1 Information - Email Address(Required)
Parent/Guardian Contact #2 Information - Name
Parent/Guardian Contact #2 Information - Email Address
Does the applicant have a history of seizures?(Required)
Emergency Contact During Class Time(Required)
Is applicant able to independently use a computer/Zoom? (This does not determine access to MPOL)(Required)

How did you hear about MPower Online Learning?(Required)
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Hours of Operation

Monday - Friday, 8am - 6pm

Contact

469-241-9100

mponline@mptx.org

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