Enrollment Agreement

One last step! Please fill out and digitally sign and confirm the enrollment agreement below to complete your enrollment process.

Your Degree Program Enrollment Agreement

Email

The email address used for the payment

First Name

Last Name

Phone #

Degrees, Diplomas & Work Experience

Degree Program Enrolled

Ph.D. Fast-Track Degree or Ph.D. Degree or M.A. Degree

Degree Program Tuition

As agreed with your enrollment advisor.

Street Address

Add a valid shipping address to receive your chart set via priority mail

Postal /ZIP Code

State/Province

Country

Enrollment Agreement Signature Date

Enrollment Signature

Add your legally valid digital signature.

Click CONFIRM & SUBMIT and watch out for your enrollment confirmation email to arrive in your inbox within a few minutes. In addition, you'll receive your LPU Student Portal login and password reset email to get you started right away. Enjoy! 😊

Lifestyle Prescriptions® University 1740 Dell Range Blvd., Suite 183 Cheyenne, WY 82009, USA

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