Online Enrollment Form

Name (Last, First, MI)
Social Security # e.g. 555-55-5555
Phone e.g. 555-555-5555	Home Cell
Email Address
Street Address
City
State	if other
Country (if not USA)
ZIP
Name of Parent/Guardian (if under 18)
Marital Status (select one)
Age
Birthdate (example 10/15/2004)
Height	ft./in.
Weight	lbs.
Sex

Would you like a Ride or Rider? Details	Ride	Rider
Would you like a meal program? Details	Breakfast, Lunch, & Dinner	Lunch Only
Room Rate Selection Details	Dbl. Occupancy	Single Occupancy	Off-Campus
How did you hear of the school?
Any health conditions?
Hat Size		if other
T-Shirt Size
Special Comments or Requests
Must read and agree to prior to submission *CANCELLATION AND REFUND POLICY* Should a student’s enrollment be terminated or canceled for any reason, all refunds will be made according to the following refund schedule: 1.Cancellation can be made in person or by Certified Mail. 2.All monies will be refunded if the school does not accept the applicant or if the student cancels within three (3) business days after signing the enrollment agreement and making initial payment. Following that time period, deposits will be forfeited if the student withdraws. Should an applicant be rejected for any reason, a full refund will be made. 3.Cancellation after the third (3rd) Business Day, but before the first class, results in a refund of all monies paid, with the exception of the registration fee (not to exceed $150.00). 4.Cancellation after attendance has begun, but prior to 50% completion of the program, will result in a Pro Rata refund computed on the number of hours completed to the total program hours. This does not include purchased meal plans. THERE ARE NO REFUNDS FOR MEAL PLANS UNDER ANY CIRCUMSTANCES. 5.Cancellation after completing 50% of the program will result in no refund. NO REFUNDS WILL BE MADE. 6.Any refunds other than tuition (room, rent), are made on a pro-rata basis of what the student has used on a day to day basis. 7.Termination Date: In calculating the refund due to a student, the last date of actual attendance or the date of cancellation by the student, whichever the latter, is used in the calculation unless earlier written notice is received. 8.Refunds will be made within 30 days of termination of students enrollment or receipt of Cancellation Notice from student. 9.Under no circumstances will the 2.5% surcharge for online or credit card payments be refunded. GROUNDS FOR TERMINATION A student’s enrollment can be terminated at the discretion of the institution for insufficient academic progress, non-payment of academic costs, or failure to comply with rules and policies established by the institution as outlined in the catalog and this agreement. Any student dismissed for these reasons shall not be afforded a refund. EMPLOYMENT ASSISTANCE Although placement assistance may be offered, the institution does not guarantee employment implied or indirectly implied. ACKNOWLEDGMENT This document and the catalog are a binding contract between the institution and applicant and no further modification or representation except as herein expressed by both parties will be recognized. CREDENTIAL AWARDED Upon satisfactory completion of the program the student will be awarded a Diploma. *DO NOT SIGN THIS CONTRACT BEFORE YOU HAVE READ IT OR IF IT CONTAINS ANY BLANK SPACES. ALL SIGNERS HAVE RECEIVED AND READ A COPY OF THE BINDING DOCUMENT AND CATALOG.* I have read and agree to the information above and herein, and by selecting this button, I acknowledge all of my rights and responsibilities.