Enrollment Agreement (Duo)

Unit 1 Class Information:

Enter Class Date(s): —Please choose an option—>> 2023 Schedule <<Oct 9th - 18th (DAY)Oct 30th - Nov 8th (DAY)Nov 27th - Dec 6th (DAY)  - - - - - - >> 2024 Schedule <<Jan 8th - 17th (DAY)Feb 5th - 14th (DAY)Mar 11th - 20th (DAY)Apr 8th - 17th (DAY)May 6th - 15th (DAY)Jun 3rd - 12th (DAY)Jul 8th - 17th (DAY)Aug 5th - 14th (DAY)Sep 9th - 18th (DAY)Oct 7th - 16th (DAY)Nov 4th - 13th (DAY)Dec 2nd - 11th (DAY)
Confirm Class Date(s): —Please choose an option—>> 2023 Schedule <<Oct 9th - 18th (DAY)Oct 30th - Nov 8th (DAY)Nov 27th - Dec 6th (DAY)  - - - - - - >> 2024 Schedule <<Jan 8th - 17th (DAY)Feb 5th - 14th (DAY)Mar 11th - 20th (DAY)Apr 8th - 17th (DAY)May 6th - 15th (DAY)Jun 3rd - 12th (DAY)Jul 8th - 17th (DAY)Aug 5th - 14th (DAY)Sep 9th - 18th (DAY)Oct 7th - 16th (DAY)Nov 4th - 13th (DAY)Dec 2nd - 11th (DAY)

Unit 1 Payment Information:

Payment Choices (Unit 1) 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 $10 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 for Unit 1 : * --read--'Payment Choices explained' above, then select one- - - - - - - - - -FULL AMOUNT OPTIONS: $600 - Full Payment + Mail Book (to address provided) $590 - Full Payment + Book (option: Office Pickup) $590 - Full Payment + Book (option: At Class)- - - - - - - - - -DEPOSIT OPTIONS: (balance due by 3pm on Thur before class) $305 - Class Deposit + Mail Book (to address provided) $295 - Class Deposit + Book (option: Office Pickup) $250 - Class Deposit only + Book (option: At Class)- - - - - - - - - -

Unit 2 Class Information:

Unit 2 Payment Information:

Tuition OPTION(s): (choose only ONE of the options below) *required

FULL AMOUNTDEPOSIT ONLY

Tuition Options explained:

• 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.

Class OPTION(s): (choose only ONE of the options below) *required
ALLSPLITPER CLASS

Class Options explained:

•  ALL WEEK CLASS(ES): I UNDERSTAND and choose the option to take all five modules/days within one month. I do not plan to split any of my classes up. If I can't attend one or more modules, I must call the office to make arrangements to reschedule to another month. Date choices must be made for All 5 modules before submitting. Payment in full will be due before class.

•  SPLITTING CLASS(ES): I UNDERSTAND and choose the option to split one or more modules/days over up to five consecutive months. This option will cost me an additional $10/each month for records management. I understand I must start and finish within five months or pay an additional $50 per class taken beyond five months. Date choices must be made for All 5 modules before submitting. Changes can be made by contacting us via phone or email. Payment in full will be due before the first class.

•  PER CLASS(ES): I UNDERSTAND and choose the option to "pay per class" and that the cost for each class will be $80. I have selected class date on this application.

PAYMENT CHOICE for Unit 2 : * Choose Payment Choices HERE:ALL WEEK OPTIONs:⯁$345 - Full Amount - All 5 days this week⬙$150 - Deposit Only (All 5 days this week - Balance Due Before Class)SPLIT MONTH(s):⯁$355 - Full Amt: SPLIT Classes over TWO months⯁$365 - Full Amt: SPLIT Classes over THREE months⯁$375 - Full Amt: SPLIT Classes over FOUR months⯁$385 - Full Amt: SPLIT Classes over FIVE months⬙$150 - Deposit Only (SPLIT Classes over TWO months)⬙$150 - Deposit Only (SPLIT Classes over THREE months)⬙$150 - Deposit Only (SPLIT Classes over FOUR months)⬙$150 - Deposit Only (SPLIT Classes over FIVE months)PER CLASS:⯁$80 - Taking Only ONE Class (Full payment due to register class)

Payment Information for both classes:

(credit card will be charged for each class separately based on the choices above)

Credit Card Issuer: * 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: *

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: —Please choose an option—ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code:

Cell Phone:
Home Phone:
Business Phone:
Fax Number:
Email Address: *
How did you hear about us? —Please choose an option—Internet/WebSocial MediaFormer StudentREALTOR®Wyatt SignWord of MouthNewspaperYellow PagesVoice MailOther

Additional Notes to Office Manager (optional):

Acceptance of Terms and Policies (both classes): *

(check both boxes below to accept, after reading the Terms and Policies for Unit 1)

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.

(check both boxes below to accept, after reading the Terms and Policies for Unit 2)

Yes, I understand the Terms and Policies as part of this agreement. I am keeping a copy for my records.

Yes, I understand #3 of the Terms and Policies require me to give timely notice or forfeit tuition paid.