Academy Application FormName:* First Last Please provide your complete name that you want on your graduation certificate, as well as any professional credentials such as RN, RD, or Ph.D, that you may already have. If you change your name prior to your class, please let us know immediately. We make the certificates as soon as the class is filled and we need everyone's correct name.Address City State / Province / Region AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone Number*Email address*For which class are you applying?*MSVA Spring (Zoom)MSVA Summer (Zoom)MSVA Autumn (in-person in NYC)How did you hear about Main Street Vegan Academy?*If an individual referred you please list name so we can thank them.MSV ELITE ONLY: do you have food allergies or other dietary restrictions? Please state yes or no. If yes, please list here the foods you are unable to consume.NOTE: We can eliminate from our menus all foods to which there are genuine allergies or medical contraindications for any student; we cannot promise accommodate every other preference. Also, if you have an allergy so severe that eating out could be a danger for you, please apply as an MSV-Zoom student.How long have you been vegan? What sparked your interest in the vegan lifestyle?Please note that you must be a dietary vegan -- no meat, fowl, fish, eggs, or dairy products -- to be accepted into this program. If you are still transitioning away from non-vegan clothing, etc., this is not a problem.Why do you wish to become an MSV-certified Vegan Lifestyle Coach and Educator?Your Digital Signature (Please type your full name)*My digital signature above confirms that: (1) I am a dietary vegan. (2) I understand that if I have paid my tuition and some emergency keeps me from participating, I will receive a refund less a $150 processing fee. (3) I understand that Main Street Vegan Academy, either in Zoom or in-person format, makes no guarantee to any student that he or she will be able to turn the certification that results from this course into a successful business or side business, although some graduates have done this. AND FOR MSV-ELITE APPLICANTS ONLY: (4) I understand and accept that MSV-Elite days start early and run long. (5) I understand that meals out and field trips via subway and walking are part of the MSV-Elite program. By signing here, I attest that I am either (a) able to walk long city blocks, sometimes in inclement weather, climb steep subway stairs, and sometimes ride the subway when no seats are available; OR (b) planning to provide my own transportation at my own expense, to the various restaurant and field trip locations, or skip this part of the program. (An inability to participate in field trips will not keep anyone from certification). (6) I understand and accept that food allergies and medical dietary restrictions will be accommodated to the fullest possible extent, but I affirm by digitally signing here that if I am applying for the MSV-Elite program, I have no serious or life-threatening allergy that would make dining in a group setting or going to a variety of restaurants dangerous for me. (7) I understand that the MSV-Elite program includes all the academic programming of MSV-Zoom program, and a life-changing life experience, field trips to NYC restaurants and businesses, breakfast 5 mornings, a welcome dinner, and drinks and snacks onsite. I am responsible for my own transportation (to and from New York and in the city), accommodations (a listing of suggested hotels and guest houses are sent with your acceptance letter), meals other than those listed above, and all miscellaneous expenses.Payment Method*Full PaymentPay in InstallmentsProduct NameMSVA Zoom Spring - $1195MSVA Zoom Summer - $1195MSVA Elite Autumn (in NYC) - $1995Please click SUBMIT and PAY below to complete the application process.Discount Code Total $0.00 Credit CardCard Details Cardholder Name ShareTweetSharePin
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