PROGRAM NAME: HHA – Home Health Aide
Name: Date Of Birth:
State: Zip Code:
Home Phone: Cell Phone:
Email: Driver’s License Number:
Name: Phone: Cell:
CNA License #
EXPLANATION OF TUITION
Program Name: HHA – Home Health Aide
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 NAME: HHA – Home Health Aide
Payment Cost : $250
CANCELLATION OF ENROLLMENT/ REFUND POLICY
Student’s Right To Cancel/Withdraw/Drop from Program
A.) The drop date for any program is 10 calendar days prior to the start of the program.
B.) Notice of cancellation, 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. Note: 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 of Program
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 calendar days prior to the start of the program (drop date).
Process For Withdrawal, Cancellation Or Dropping A Course
FAILURE TO SUBMIT WRITTEN NOTICE BY DROP DATE:
Failure to submit a written intent to cancel, withdraw, or cancel at least 10 calendar days before the start of the program (drop date) will make student responsible for full tuition and costs. (initial)
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 a refund and will be responsible for full tuition and costs.
Refund Policy Summation:
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 calendar days. Class being rescheduled does not constitute cancellation as long as the rescheduled class is held within 90 days of the original start date.
OTHER STUDENT RESPONSIBILITIES:
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:
One-on-One Instructor Make Up Class
Students will be financially responsible for payment of instructor for one-on-one teaching for any missed days.
If a one-on-one make up 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 Postsecondary 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
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 enroll ent agreement form and the explanation of tuition, fees and cancellation of enrollment, student handbook or catalog 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, und
Leave this empty:
Signed by Kristy Farook
Signed On: March 11, 2017
If you have questions about the contents of this document, you can email the document owner.
Document Name: HHA Enrollment
Agree & Sign