Orion Topeka 2019-2020 Interest Form
Thank you for your interest! Before you start filling out this form, please read the following:

PERSONAL EMAIL ADDRESS - you will need to provide your own, valid, working email address on this form. Your enrollment form will be sent to this email, so please make sure it belongs to you, it works, and you can access it.
If you need to create an email address, or create a NEW email address, please do so now. We recommend using a gmail address, which can be created at the following link: https://accounts.google.com/SignUp?hl=en

If you do not have a personal email and choose not to create a new one, please contact our office for on-site enrollment information. 785-228-2336 5331 SW 22nd Place (inside Fairlawn Plaza Mall).

COMPUTER - Please fill out this form on a desktop or laptop computer. Mobile devices may not work correctly. You will also need a desktop or laptop computer to work on your courses, as mobile devices are not compatible with our coursework program.

If you do not have access to a desktop or laptop computer, you are welcome to use the computer lab at our physical location: 5331 SW 22nd Place (inside Fairlawn Plaza Mall) Topeka, KS 66614.

This computer lab is open throughout the school year for students to work on courses.

ARE YOU THE ONE INTERESTED? Please DO NOT fill out this form for a child, friend, family member, etc. Honesty and Integrity in our program begins now.

If you have a personal email that works, and you are filling out this form yourself on a desktop or laptop computer, please proceed to the next step.


First Name *
Please enter your LEGAL first name only.
Your answer
Middle Name *
Please enter your LEGAL middle name only. If you do not have a middle name, please type "N/A".
Your answer
Last Name *
Please enter your LEGAL last name only
Your answer
Generation Code
Please select if you have a generation code attached to your name. If you don't know what a generation code is, you probably don't have one.
Main Phone *
Please give us a phone number where you can always be reached or a message can get to you. Ex. 785-228-2336
Your answer
Cell Phone
If your cell phone number is also your main number, please type it again. Ex. 785-228-2336
Your answer
May we text you? *
Email Address *
Any student expecting to work online from home or another facility needs to provide a working email address. Please share an email address that you check frequently. Email is also required for online enrollment.
Your answer
Have you enrolled with Orion Topeka (or New Directions Learning Academy) before? *
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