CNA Program Special
PROGRAM NAME: CNA 101
Start Date/Completion Date:
May 10th 2021 (Weekday)May 24th 2021 (Evening)June 21st 2021 (Weekday)June 26th 2021 (Weekend)
Name: Date Of Birth:
State: Zip Code:
Home Phone: Cell Phone:
Email: Driver’s License Number:
Name: Phone: Cell:
Degree’s Earned: Associates Bachelor's Masters Doctorate
Years of Study:
High School Completion, GED or Equivalent WMTC does not Require High School Diploma for Enrollment.
Some National Certifications may require GED or Equivalent, for example: PTCB & NCCT
I certify that I graduated from:_ High School on
or Earned my GED or HS Equivalency on:
Do You Have Any Felony Convictions?
YesNo If Yes, explain:
Who Referred You? (You must enter the person's first and last name who referred you here for the person to be eligible for referral bonus)
EXPLANATION OF TUITION
Program Name: CNA 101
Non Refundable Cost
The Enrollment Fee of $100.00 is non-refundable, however, it is applied towards student’s tuition.
Students are responsible for paying for all applications and State/National Licensing or Certification exams through CDPH, NCCT & PTCB.
Additional Costs not Included in Tuition
Students are responsible for paying:
This Payment Agreement is entered into by and between Western Medical Training Center & , and they hereby agree upon the terms stated within this agreement.
PROGRAM COST: $1500-$100(Non-Refundable Registration Fee) = $1400
CNA Weekday Program: March 29th - April 28th 2021
Payment of $400 Due On Orientation Day March 29th 2021Payment of $500 Due - April 6th 2021Payment of $500 Due on Graduation Day - April 28th 2021
CNA Weekday Program: May 10th - June 10th 2021
Payment of $400 Due On Orientation Day May 10th 2021Payment of $500 Due - May 21st 2021Payment of $500 Due on Graduation Day - June 10th 2021
CNA Weekday Program: June 21st - July 22nd 2021
Payment of $400 Due On Orientation Day June 21st 2021Payment of $500 Due - July 9th 2021Payment of $500 Due on Graduation Day - July 22nd 2021
CNA Evening Program: March 15th - May 17th 2020
Payment of $400 Due On Orientation Day March 15th 2021Payment of $500 Due On April 23rd 2021Payment of $500 Due on Graduation Day - May 17th 2021
CNA Evening Program: May 24th - July 28th 2021
Payment of $400 Due On Orientation Day May 24th 2021Payment of $500 Due On June 25th 2021Payment of $500 Due on Graduation Day - July 28th 2021
CNA Weekend Program: March 27th - June 13th 2021
Payment of $400 Due On Orientation Day March 27th 2021Payment of $500 Due - April 17th 2021Payment of $500 Due on Graduation Day - June 13th 2021
CNA Weekend Program: June 26th - September 18th 2021
Payment of $400 Due On Orientation Day June 26th 2021Payment of $500 Due - July 17th 2021Payment of $500 Due on Graduation Day - September 18th 2021
**There is NO Penalty For Early Payment**
I certify that I have read, understand and agree to the Payment Agreement as outlined herein, and I have received a true copy of this document and will retain said copy for my records.
CANCELLATION OF ENROLLMENT/ REFUND POLICY
STUDENT'S RIGHT TO CANCEL
A.) The drop date for any program is 10 business days prior to the start of the program.
B.) Notice of cancellations, withdrawal, or drop must be submitted in writing before the program drop date, and must be signed and dated by the student or legal guardian. Not: a student's lack of attendance does not mean that student will be dropped from the program.
(Example; If student has registered for an upcoming class and never shows up for the class, and does not provide a written notice prior to the drop date; then the student will receive a failing grade for the course and will not be eligible for a refund.)
Cancellation/Withdrawal/Drop Prior to Start Date:
Students may cancel, withdraw, or drop from a program prior to the drop date. Cancellations, withdrawals or drops must be submitted in writing no later than 10 business days prior to the class start date.
Process For Withdrawal, Cancellation or Dropping a Program
FAILURE TO SUBMIT WRITTEN NOTICE BY DROP DATE
Failure to submit a written intent to cancel, withdraw, or drop at least 10 business days prior to the program start date will make the student responsible for the full tuition and costs.
Cancellation of Enrollment After Start of Program
Students who cancel, withdraw, or drop from a program after the start of the program, will not be entitled to refund and will be responsible for full tuition and costs.
Refund Policy Summation:
MUST DROP 10 BUSINESS DAYS PRIOR TO CLASS START DATE
REGISTRATION FEE IS NOT TRANSFERABLE, AND CAN NOT BE USED TO REGISTER FOR ANOTHER CLASS
TUITION FEES PAID ARE NOT TRANSFERABLE TO OTHER PROGRAMS OR OTHER INDIVIDUALS
Students who drop After the drop date (10 business days prior to the class start date) and have paid the tuition in full will be able to take the same program in the future by being placed on a waiting list. The waiting list does not guarantee a seat in the upcoming schedule. WMTC will make a good faith & reasonable effort to place the student in a schedule with available seat.
Accounts sent to collections: If an account is sent to collections for non-payment or excessive late payments student will have the option to complete the training if the following conditions are met:
*Important Note – Student will be responsible for any charges the college has paid on their behalf for the above stated program including but not limited to: Live Scan Fingerprinting, Textbook, Workbook, Uniform, CPR certification course, Stethoscope, Gait belt, and all other items related to the specific course in which the student has enrolled. The items listed above are not provided in all courses.
Student Cancellation and Return Of Course Materials, Textbook, Equipment and/or Uniform
WMTC Course Or Program Cancellation
If the school cancels the program before the first day of class, the school will refund all money including deposit paid to students within 45 business days. Class being rescheduled does not constitute cancellation as long as the rescheduled class is held within 90 days of the original start date.
Confirmation For Class
You MUST Confirm by Text, Email, or Phone when we send out confirmation for the class. Failure to respond can result in you being dropped from the class, even if before the 10 business day drop date. Any contact information must be updated A.S.A.P so that we can contact you.
The following constitute grounds for dismissal from the training:
Suspension and Dismissal
Students are expected to conduct themselves professionally at all times, and to follow protocols and expectations as outlined in the policies and procedure sections of the student handbook.
The school reserves the right to suspend or dismiss any students who:
Regular school attendance is a necessary part of the learning process and the means to graduation with a good education. Absenteeism, especially tardiness, is a behavior that is highly associated with dropping out of school. Regular attendance is essential for success in school.
Additional absences will result in being dropped from the program.
Before any dismissal of student from the program, school administrator will organize a meeting with director of nursing & the instructor to discuss student overall performance and behavior. If the recommendation is to give the student 1 additional chance, keeping in mind students best interest. As long as finding accommodation is not too difficult and make up is according to California Department of Public Health policy.
Example: If a one-on-one makeup class is required, the student will be charged $40 per instructional hour for each hour of missed theory, lab or clinical time, i.e. 8 hours missed x $40 = $320.
NOTICE CONCERNING TRANSFER-ABILITY OF CREDITS AND CREDENTIALS EARNED AT OUR INSTITUTION
The transfer-ability of credits you earned at Western Medical Training Center is at the complete discretion of an institution to which you may seek to transfer. Acceptance of the program completion certificate you earn in our school training programs is also at the complete discretion of the institution to which you may seek to transfer. If the credits or certificate that you earn at this institution are not accepted at the institution to which you seek to transfer you may be required to repeat some or all of your coursework at that institution. For this reason you should make certain that your attendance at this institution will meet your educational goals. This may include contacting an institution to which you may seek to transfer after attending Western Medical Training Center to determine if your credits or certificate will transfer.
I hereby acknowledge the following:
Bureau For Private Post Secondary Education
Physical address: 2535 Capital Oak Dr., Suite 400, Sacramento California, 95833
Mailing address: PO Box 980818, West Sacramento, CA 95798-0810
Phone Number: 916-431-6959 / Toll Free: 888-370-7589 / Fax Number: 916-263-1897
2 Sets of Uniform.
Live Scan Fingerprinting For CNA(Background Check).
Textbook (Always has to be returned at the end of the course).
Physical Examination & PPD Skin Test.
X-Ray (Only if PPD is positive)
National Certification Exam Fees. (NCCT or PTCB)
State exam handbook
Print Student Name Date
I verify that the stated information in this Enrollment Agreement is true and accurate to the best of my knowledge. I agree that the course enrollment procedure and explanation of tuition and fees has been fully explained to me. I acknowledge that I have received a copy of the enrollment agreement form and the explanation of tuition, fees and cancellation of enrollment, student handbook and performance fact sheet.
I understand that in consideration to all applicants, seat availability for this course is offered on a first-come first-served basis. Acceptance is dependent upon the successful completion of the application form, payment of enrollment fee, live scan fingerprinting application and submission, physician statement of eligibility to train.
I understand that there is limited seat availability and that my application does not guarantee me a seat until confirmed by administration.
I understand that this enrollment agreement when signed by the student and accepted by Western Medical Training Center is a legally binding contract. My signature below certifies that I have read, understood, and agree to my rights and responsibilities, and that the institutions cancellation and refund policies have been clearly explained to me.
The clinical training is designed to provide you with the essential skills necessary to enter the health care profession as a Certified Nurse Assistant. Please keep in mind that we are a guest in the facility we use for the required clinical experience. It is essential that we act in a professional manner at all times.
I have read, understand and agree to comply with the rules stated above.
Method of Student Evaluation For CNA Program
Certified nursing assistant students will be graded in two parts...
Students will be graded by means of taking a quiz for each theory module. Quizzes will be averaged to give the final theory grade. A final theory grade will be divided as follows. Test and quizzes will equal 60% of the theory grade,20% for attendance and professionalism, and the remaining 30% will be assignments and projects. Students require a minimum of 75%/ C to pass the didactic portion of the program.
1.) If the student does not pass the theory portion of the program he or she will be required to repeat the theory portion until they obtain a passing grade.
B) CLINICAL PERFORMANCE/PARTICIPATION
Students will be graded by means of clinical performance objectively evaluated by the instructor. Each student will be required to successfully obtain at least one set of vital signs for their client. In addition the student will be required to satisfactorily assist their client with personal care tasks. A final Pass/Fail grade will be awarded to each students upon completion of the clinical training portion of the program
**STUDENTS MUST PASS BOTH PORTIONS ABOVE TO QUALIFY FOR THE STATE EXAM***
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Your legal name
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Signed by Kristy Farook
Signed On: February 25, 2021
If you have questions about the contents of this document, you can email the document owner.
Document Name: CNA Program Special
Agree & Sign