Enrollment Agreement (U1) Unit 1 Application Class Information: Enter Class Date(s): ---Mar 8th - 17th (DAY)Apr 12th - 21st (DAY)May 3rd - 12th (DAY)May 10th - June 3rd* (NIGHT)Jun 7th - 16th (DAY)Jul 5th - 14th (DAY)Aug 9th - 18th (DAY)Sep 13th - 22nd (DAY)Sep 20th - Oct 14th (NIGHT)Oct 11th - 20th (DAY)Nov 1st - 10th (DAY)Nov 29th - Dec 8th (DAY) Confirm Class Date(s): ---Mar 8th - 17th (DAY)Apr 12th - 21st (DAY)May 3rd - 12th (DAY)May 10th - June 3rd* (NIGHT)Jul 5th - 14th (DAY)Sep 20th - Oct 14th (NIGHT)Aug 9th - 18th (DAY)Sep 13th - 22nd (DAY)Jun 7th - 16th (DAY)Oct 11th - 20th (DAY)Nov 1st - 10th (DAY)Nov 29th - Dec 8th (DAY) * indicates REQUIRED fields below Student Information: Have you attended classes here before?* YesNo Company Name: First Name:* Middle Name: Last Name:* Nickname: for class purposes Social Security Number:* Street Address: City: State: ---ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Home Phone: Business Phone: Fax Number: Cell Phone: Email Address:* How did you hear about us? ---Internet/WebSocial MediaFormer StudentREALTOR®Wyatt SignWord of MouthNewspaperYellow PagesVoice MailOther 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 : *--read--'Payment Choices explained' above, then select one- - - - - - - - - -FULL AMOUNT OPTIONS: $558 - Full Payment + Mail Book (to address provided) $550 - Full Payment + Book (option: Office Pickup) $550 - Full Payment + Book (option: At Class)- - - - - - - - - -DEPOSIT OPTIONS: (balance due by 3pm on Thur before class) $303 - Class Deposit + Mail Book (to address provided) $295 - Class Deposit + Book (option: Office Pickup) $250 - Class Deposit only + Book (option: At Class)- - - - - - - - - - CHARGE to Credit Card: *choose one:VISAMasterCard «« 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: * Additional Notes to Office Manager (optional): Acceptance of Terms and Policies:* (check both boxes below to accept, after reading the Terms and Policies) Yes, I understand the Terms and Policies as part of this agreement. I am keeping a copy for my records. Yes, I understand #2 of the Terms and Policies require me to give timely notice or forfeit $250 if I do not show.