Enrollment Agreement (U1)

Unit 1 Application

    Class Information:

    Enter Class Date(s):
    Confirm Class Date(s):

    * indicates REQUIRED fields below

    Student Information:

    Have you attended classes here before?* YesNo






    Social Security Number:*








    Payment Information:

    Payment Choices explained:

    TUITION options:

    • Either FULL Amount (or) DEPOSIT will hold your seat in class; balance due by 3pm on the Thursday before class begins.
    • Credit Card is required for all ONLINE submissions.
    • Checks, Cash, and Money Orders accepted at the office or by mail.

    TEXTBOOK options:

    • Book is included in price
    • To get a head start, you can request the book before class: (recommended)
      • {option: Mail Book} We will mail book to the address provided on this form. (includes $8 for shipping fee.)
      • {option: Office Pickup} Come by the office to pick book up (no charge)
    • Book will be given first day of class, if {option: At Class} is selected

    PAYMENT CHOICE : *
    CHARGE to Credit Card: * «« VISA or MasterCard ONLY
    Card #: *
    3-digit security code: *
    Expiration Date (MM/YY): *

    Name on Card: *
    Billing Address Number (used to process credit card): * (numbers ONLY)
    Billing Zip Code: *


    Acceptance of Terms and Policies:*

    (check both boxes below to accept, after reading the Terms and Policies)

    , I understand the Terms and Policies as part of this agreement. I am keeping a copy for my records.
    , I understand #2 of the Terms and Policies require me to give timely notice or forfeit $250 if I do not show.