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| ENROLLMENT AGREEMENT CANYON STATE LASER TRAINING 4045 E. BELL ROAD #157 PHOENIX, AZ 85032 (602) 996-4975 PH (602) 404-6514 FAX
STUDENT NAME:__________________________________________________ PRESENT ADDRESS: PERMANENT ADDRESS: _____________________________ _____________________________ _____________________________ _____________________________ TELEPHONE (HOME): ________________ (CELL): _________________ SOCIAL SECURITY NO: ________________ E-MAIL: ___________________________ PROGRAM INFORMATION: PROGRAM: ________________________ PROGRAM LEGNTH: _________________(SPECIFIED IN CLOCK HRS) TUITION: THE TOTAL COST FOR THE ___________ PROGRAM: TUITION: $4,500.00 ADMINISTRATION/REGISTRATION FEE: ________ BOOKS/SUPPLIES: ________ TOTAL PROGRAM COST: ________ TUITION PAYMENTS: 1. TUITION DEPOSIT OF _________ IS DUE WITH SIGNING OF THE ENROLLMENT AGREEMENT. THE DEPOSIT WILL BE APPLIED AS FOLLOWS: 2. BALANCE OF TUITION OPTIONS: A. DUE NO LATER THAN _____ WEEKS PRIOR TO CLASS, PAYABLE BY CASH, CHECK OR CREDIT CARD.
B. THESE PAYMENTS ARE AVAILABLE TO ALL STUDENTS. CANCELLATION AND REFUND POLICY: REJECTION: AN APPLICANT REJECTED BY THE SCHOOL IS ENTITLED TO A REFUND OF ALL MONIES PAID. THREE-DAY CANCELLATION: AN APPLICANT WHO PROVIDES WRITTEN NOTICE OF CANCELLATION WITHIN THREE DAYS (EXCLUDING SATURDAY, SUNDAY AND FEDERAL AND STATE HOLIDAYS) SIGNING AN ENROLLMENT AGREEMENT IS ENTITLED TO A REFUND OF ALL MONIES PAID. NO LATER THAN 30 DAYS OF RECEIVING THE NOTICE OF CANCELLATION, THE SCHOOL SHALL PROVIDE THE 100% REFUND. OTHER CANCELLATIONS: AN APPLICANT REQUESTING CANCELLATION MORE THAN 3 DAYS AFTER SIGNING AN ENROLLMENT AGREEMENT AND MAKING AN INITIAL PAYMENT, BUT PRIOR TO ENTERING THE SCHOOL, IS ENTITLED TO A REFUND OF ALL MONIES PAID (MINUS AN ADMINISTRATIVE/REGISTRATION FEE OF $________ , NOT TO EXCEED $200 IF APPLICABLE.) REFUND AFTER THE COMMENCEMENT OF CLASSES: 1. PROCEDURE FOR WITHDRAWL/WITHDRAWL DATE: A. A STUDENT CHOOSING TO WITHDRAW FROM THE SCHOOL AFTER THE COMMENCEMENT OF CLASSES IS TO PROVIDE WRITTEN NOTICE TO THE DIRECTOR OF THE SCHOOL. THE NOTICE IS TO INDICATE THE EXPECTED LAST DATE OF ATTENDANCE AND BE SIGNED AND DATED BY THE STUDENT. B. FOR A STUDENT WHO IS ON AUTHORIZED LEAVE OF ABSENCE, THE WITHDRAWL DATE IS THE DATE THE STUDENT WAS SCHEDULED TO RETURN FROM THE LEAVE AND FAILED TO DO SO. C. A STUDENT WILL BE DETERMINED TO BE WITHDRAWN FROM THE INSTITUTION IF THE STUDENT HAS NOT ATTENDED ANY CLASS FOR 30 CONSECUTIVE DAYS. D. ALL REFUNDS WILL BE ISSUED WITHIN 30 DAYS OF THE DETERMINATION OF THE WITHDRAWL DATE. 2. TUITION CHARGES/REFUNDS: BEFORE THE BEGINNING OF CLASSES, THE STUDENT IS ENTITLED TO A REFUND OF 100% OF THE TUITION (LESS THE REGISTRATION FEE, NOT TO EXCEED $200, IF APPLICABLE.) AMOUNT SHALL BE DETERMINED AS FOLLOWS: % OF THE CLOCK HOURS ATTEMPTED: TUITION REFUND AMOUNT: 10 % OR LESS AT LEAST 90% MORE THAN 10% AND LESS THAN OR EQUAL TO 20% AT LEAST 80% MORE THAN 20% AND LESS THAN OR EQUAL TO 30% AT LEAST 70% MORE THAN 30% AND LESS THAN OR EQUAL TO 40% AT LEAST 60 % MORE THAN 40% AND LESS THAN OR EQUAL TO 50% AT LEAST 50% MORE THAN 50% NO REFUND IS REQUIRED THE PERCENTAGE OF THE CLOCK HOURS ATTEMPTED IS DETERMINED BY DIVIDING THE TOTAL NUMBER OF CLOCK HOURS ELAPSED FROM THE STUDENT’S START DATE TO THE STUDENT’S LAST DAY OF ATTENDANCE, BY THE TOTAL NUMBER OF CLOCK HOURS IN THE PROGRAM. BOOKS, SUPPLIES AND FEES: (ALL INCLUDED) REFUNDS: WILL BE ISSUED WITHIN 30 DAYS OF THE DATE OF STUDENT NOTIFICATION, OR DATE OF SCHOOL DETERMINATION (WITHDRAWN DUE TO ABSENCES OR OTHER CRITERIA AS SPECIFIED IN THE CATALOG) , OR IN THE CASE OF A STUDENT NOT RETURNING FROM AN AUTHORIZED LEAVE OF ABSENCE (LOA) WITHIN 30 DAYS OF THE DATE THE STUDENT WAS SCHEDULED TO RETURN FROM THE (LOA) AND DID NOT RETURN. HOLDER IN DUE COURSE STATEMENT: ANY HOLDER IF THIS CONSUMER CREDIT CONTRACT IS SUBJECT TO ALL CLAIMS AND DEFENSES WHICH THE DEBTOR COULD ASSERT AGAINST THE SELLER OF GOODS OR SERVICES OBTAINED PERSUANT HERETO OR WITH THE PROCEEDS, HEREOF RECOVERY HEREUNDER BY THE DEBTOR SHALL NOT EXCEED AMOUNTS PAID BY THE DEBTOR (FTC RULE EFFECTIVE 5-14-76) THE STUDENT UNDERSTANDS: 1. THE SCHOOL DOES NOT ACCEPT CREDIT FOR PREVIOUS EDUCATION, TRAINING, WORK EXPERIENCE (EXPERIMENTAL LEARNING) , OR CLEP. 2. THE SCHOOL DOES NOT GUATRANTEE JOB PLACEMENT TO GRADUATES UPON PROGRAM /COURSE COMPLETION OR UPON GRADUATION. 3. THE SCHOOL RESERVES THE RIGHT TO RESCHEDULE PROGRAM START DATE WHEN THE NUMBER OF STUDENTS IS TOO SMALL. 4. THE SCHOOL WILL NOT BE RESPONSIBLE FOR ANY STATEMENT OF POLICY OR PROCEDURE THAT DOES NOT APPEAR IN THE SCHOOL CATALOG. 5. THE SCHOOL RESERVES THE RIGHT TO DISCONTINUE THE STUDENT’S TRAINING FOR UNSATISFACTORY PROGRESS, NONPAYMENT OF TUITION OR FAILURE TO ABIDE BY SCHOOL RULES. 6. INFORMATION CONCERNING OTHER SCHOOLS THAT MAY ACCEPT THE SCHOOL’S CREDITS TOWARD THEIR PROGRAMS CAN BE OBTAINED BY CONTACTING THE OFFICE OF THE PRESIDENT. IT SHOULD NOT BE ASSUMED THAT ANY PROGRAMS DESCRIBED IN THE SCHOOL CATALOG COULD BE TRANSFERRED TO ANOTHER INSTITUTION. 7. THIS DOCUMENT DOES NOT CONSTITUTE A BINDING AGREEMENT UNTIL ACCEPTED IN WRITING BY ALL PARTIES. STUDENT ACKNOWLEDGEMENTS: 1. I HEREBY ACKNOWLEDGE RECIPT OF THE SCHOOL’S CATALOG DATED_________ , WHICH CONTAINS INFORMATION DESCRIBING PROGRAMS OFFERED, AND EQUIPMENT/SUPPLIES PROVIDED. THE SCHOOL’S __________ CATALOG IS INCLUDED AS A PART OF THIS ENROLLMENT AGREEMENT, AND I ACKNOWLEDGE THAT I HAVE RECEIVED A COPY OF THIS CATALOG ___________ STUDENT INITIALS. 2. ALSO, I HAVE CAREFULLY READ AND RECEIVED AN EXACT COPY OF THIS ENROLLMENT AGREEMENT. ___________STUDENT INITIALS. 3. I UNDERSTAND THET THE SCHOOL MAY TERMINTATE MY ENROLLMENT IF I FAIL TO COMPLY WITH ATTENDANCE, ACADEMIC AND FINANCIAL REQUIREMENT OR IF I DISRUPT THE NORMAL ACTIVITIES OF THE SCHOOL. WHILE ENROLLED IN THE SCHOOL. I UNDERSTAND THAT I MUST MAINTAIN SATISFACTORY ACADEMIC PROGRESS AS DESCRIBED IN THE SCHOOL CATALOG AND THAT MY FINANCIAL OBLIGATION TO THE SCHOOL MUST BE PAID IN FULL BEFORE A CERTIFICATE MAY BE AWARDED. 4. I ALSO UNDERSTAND THAT THIS INSTITUTION DOES NOT GUARANTEE JOB PLACEMENT TO GRADUATES UPON PROGRAM/COURSE COMPLETION OR UPON GRADUATION. ___________STUDENT INITIALS. CONTRACT ACCEPTANCE: I, THE UNDERSIGNED, HAVE READ AND UNDERSTAND THIS AGREEMENT AND ACKNOWLEDGE RECIPT OF A COPY. IT IS FURTHER UNSERSTOOD AND AGREED THAT THIS AGREEMENT SUPERSEDES ALL PRIOR OR CONTEMPORANEOUS VERBAL OR WRITTEN AGREEMENTS AND MAY NOT BE MODIFIED WITHOUT THE WRITTEN AGREEMENT OF THE STUDENT OR SCHOOL OFFICIAL. I ALSO UNDERSTAND THAT IF I DEFAULT UPON THIS AGREEMENT I WILL BE RESPONSIBLE FOR PAYMENT OF ANY COLLECTION FEES OR ATTORNEY FEES INCURED BY CANYON STATE LASER TRAINING MY SIGNATURE BELOW SIGNIFIES THAT I HAVE READ AND UNDERSTAND ALL ASPECTS OF THIS AGREEMENT AND DO RECOGNIZE MY LEGAL RESPONSIBILITIES IN REGARD TO THIS CONTRACT. SIGNED THIS ______DAY OF _____20_____ ___________________________________ ___________________________ SIGNATURE OF STUDENT DATE ___________________________________ ___________________________ SIGNATURE OF SCHOOL OFFICIAL DATE REPRESENTITIVE’S CERTIFICATION: I HEREBY CERTIFY THAT ___________________________ HAS BEEN INTERVIEWED BY ME AND IN MY JUDGEMENT, MEETS ALL REQUIREMENTS FOR ACCEPTANCE AS A STUDENT. I FURTHER CERTIFY THAT THERE HAVE BEEN NO VERBAL OR WRITTEN AGREEMENTS OR PROMISES OTHER THAN THOSE APPEARING IN THIS AGREEMENT. BY:_______________________________ DATE:_________________________ STUDENT GRIEVANCE PROCEDURE IF A STUDENT COMPLAINT CANNOT BE RESOLVED AFTER EXHAUSTING THE INSTITUTION’S GRIEVANCE PROCEDURE, THE STUDENT MAY FILE A COMPLAINT WITH THE ARIZONA STATE BOARD FOR PRIVATE POST-SECONDARY EDUCATION. THE STUDENT MUST CONTACT THE STATE BOARD FOR FURTHER DETAILS. THE STATE BOARD ADDRESS IS: 1400 W. WASHINGTON, ROOM 260 PHOENIX, AZ 85007 PHONE: 602-542-5709 WEBSITE HTTP://AZPPSE.STATE.AZ.US |
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