Training Enrollment Request

TRAINING ENROLLMENT REQUEST

Student Information

Applicant is a minor under 18: (If checked, parent/guardian information and signature are required below.)

Parent / Guardian (if applicant is a minor)

Program / Training Details

Delivery method (select all that apply):

In-person    Online (synchronous)    Online (asynchronous)    Hybrid

Tuition, Fees & Payment

Payment option (select one):

Full payment due upon registration    Installment plan    Invoice employer / third party

Prerequisites & Documents

I confirm I meet the program prerequisites:

Required documents submitted (check all that apply):

Government-issued ID    Transcript or proof of education    Employer authorization

Proof of payment / PO number provided

Emergency & Medical Information

Acknowledgments, Terms & Policies

By submitting this Training Enrollment Request, the applicant certifies under penalty of perjury that the information provided is true and complete, and agrees to the following terms. Applicant acknowledges that enrollment is not confirmed until payment or employer authorization is accepted and a seat is assigned in writing by program administration.

Attendance and completion requirements: Applicant understands that satisfactory attendance, timely completion of assigned work, and any required assessments are conditions for awarding certification or continuing enrollment. Failure to meet attendance or completion standards may result in removal from the program without refund.

Fee responsibility and refunds: Applicant is financially responsible for tuition and fees unless employer billing has been approved in writing. Cancellation by applicant 14 or more days prior to start: full refund less any non-recoverable processing fees. Cancellation 7–13 days prior: 50% refund. Cancellation within 7 days of start or after program start: no refund, unless otherwise required by written agreement. Materials fees may be non-refundable.

Code of conduct and liability: Applicant agrees to comply with all program rules and the instructor directives. Applicant hereby releases the training provider and its instructors from liability for incidental injury or loss except to the extent resulting from gross negligence or willful misconduct. Applicant consents to emergency medical treatment if required and agrees to be responsible for any associated costs.

Records and privacy: Applicant authorizes release of enrollment and certification records to accrediting bodies, employers (where authorized), and funding entities for the purposes of program administration, funding verification, and placement. The provider will maintain personally identifiable information in accordance with institutional privacy practices.

Acknowledgments (check each to confirm):
I acknowledge the attendance and completion requirements.
I will comply with the program code of conduct.
I accept financial responsibility for fees not covered by a third party.
I understand the cancellation and refund policy.
I understand the certification and assessment requirements.
I consent to the release of records as described above for administrative purposes.
I acknowledge the liability provisions and emergency medical consent.
I consent to use of non-identifying photos/recordings for program promotion (optional).

Administrative / Employer Billing (if applicable)

Employer will pay training fees:

Acknowledgment & Signature

Certification: I certify that the information provided on this Training Enrollment Request is accurate and complete. I have read, understand, and agree to the terms and policies set forth in this form. I authorize release of records as indicated and accept responsibility for fees unless otherwise arranged in writing.

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