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 : $305.00
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 30 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.
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:
With the approval from the RN Program Director, the instructor will set aside 1 day prior to going to the clinical portion of the class. This day would be for makeup class for a student who missed a theory day which included topics required to meet the regulations in Title 22 before going to the clinical portion of the class. If there is room in other schedules were the same topics can be made up by the student, this would also be an acceptable form of makeup.
One on one option where student can pay for one on one instruction prior to clinical training would also be a last resort option for the student. If the above options are not available due to time and scheduling restraints the students who missed two (2) or more days of theory, these students will need to wait for the next class to make up those topics missed and will have to finish out the program including clinical portion with the next class given the availability of space.
OTHER STUDENT RESPONSIBILITIES:
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, understood, and agree to my rights and responsibilities, and that the institutions cancellation and refund policies have been clearly explained to me.
Leave this empty:
Signed by Kristy Farook
Signed On: January 5, 2019
If you have questions about the contents of this document, you can email the document owner.
Document Name: Student HHA
Agree & Sign