Enroll in the Online NAC Please submit this form to enroll in the Online National Administrator Credential (NAC). Name First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Online NAC Self-Pay Tuition* Price: This purchase will allow you take the Online National Administrator Credential (NAC) courses to earn your NAC. You have 180 days to complete the course starting from the time of enrollment. Candidates with a Scholarship: Please call NECPA to enroll at 855.706.3272.Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name Consent* I agree to the following policies.Name changes: In the event your account has the incorrect name, name changes must be made within 30 days of purchase and prior to beginning the course. If a request is made after this allotted period and prior to beginning a course, the student may be responsible for an administrative fee. No name changes will be made after a course has been completed. Refunds for online courses: If the request to cancel an order is received within thirty (30) days from the purchase date and prior to starting a lesson, a refund minus processing fees will be issued to the purchaser. Any use of the web-based product constitutes full use and negates any refund. Refunds for Manuals/Textbooks: If a course refund request is received, the NAC text book is required to be sent back at the candidate's expense and in new condition. A refund minus processing and restocking fees will be issued to the customer. Any identifiable use of the product constitutes full use of the textbook, and a $40 fee will be withheld from the course refund, if any be due. Course Availability: This course will be available to the candidate for 180 days, starting the day of enrollment. If the candidate is unable to complete the course within 180 days, the candidate may be allowed to purchase extended access to the course. If a candidate is progressing through the class in a manner which is deemed unnatural, the candidate may be warned to slow down. The candidate is expected to operate this course in good faith and with complete academic honesty. Any abuse of this course, including plagiarism or cheating in any other manner may terminate the candidate's participation in this course. SignatureToday's Date MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged. Δ