CTEL: 773-253-2992

ADMIN:312-723-4654

FAX: 833-624-1730

Chicago Instruction Center for Career Development, LLC

WEBSITE: E-MAIL: info@chicagoinstructioncenterforcareerdevelopment.com

ENROLLMENT AGREEMENT

STUDENT INFORMATION     (PLEASE PRINT)  REGISTRATION DATE: _________________________

STUDENT NAME:  _________  SOCIAL SECURITY: _____--_________--______

 First   MI    Last 

ADDRESS: __________________________________________________________________________________________

# Street    City                       State                      Zip Code

PHONE NUMBERS: (Home) _________________ (Cell) _________

EMAIL ADDRESS:__________________________@______________________

EMERGENCY CONTACT:___________________________RELATIONSHIP:_________________TEL#:_________

PROGRAM / COURSE NAME: (Circle One)  Phlebotomy Technician 

PROGRAM START DATE: _______________ SCHEDULED END DATE: ______________­­­­_ NUMBER OF WEEKS: ___ 

DAY   EVENING WEEKEND  CLASS MEETS:   (circle)  MON TUES WED THURS FRI SAT  SUN

TIME CLASS BEGINS: _________TIME CLASS ENDS: __________TOTAL CREDIT or CLOCK HOURS:  70 Clock hrs 

Tuition & other fees: NON-REFUNDABLE REGISTRATION FEE: $ 75.00  We do not process any form of FINANCIAL AID and CASH IS NOT ACCEPTED 

Course Program

Phlebotomy Technician

Miscellaneous   Expense

(cost of  each may vary)

Tuition

$825.00

Registration Fee:

$250.00

 Additional Fees:

$185.00

Additional Fees breakdown

Textbook(s)   - $130

 Laboratory safety jacket & patch - $40

Supplies -   $15 

Additional CPR :

$65.00

CPR is   not required, but is offered

Grand Total

$1,260 – no CPR

$1,310 – with CPR

1st Payment Received

$

Date

2nd Payment Received

$

Date

Final Payment Received

$

Date

Cash 

NOT ACCEPTED

Check

Money Order

Credit Card 

Note: Please check the method of payment

1stInstallment (Upon Registration includes Registration Fee)   $667.50 1st Installment

2nd Installment (3rd week of the program)      $296.25 2nd Installment

Final Installment (6th week of program)    $296.25 Final Installment

CPR Fee paid separate prior to CPR Class

Note: 50% of Tuition due at time of registering for class and 25% due at week 3 and 25% due at week 6- Program Completion. Students with unpaid Tuition cannot have degree conferred and receive certificate of completion for the Phlebotomy Technician Program.

REFUND / CANCELLATION / WITHDRAWAL POLICY 

STUDENT’S RIGHT TO CANCEL

The student has the right to cancel the initial enrollment agreement until midnight of the 5th business day after the student has been admitted (Registration Date). Cancellation should be submitted to the authorized official of the school in writing.

Registration Date is the same of the Acceptance Date

1. Student must submit a written notice of cancellation or withdrawal

2. School shall, when a student gives written notice of cancellation, provide a refund in the amount of at least the following:

a. When notice of cancellation is given before midnight of the fifth (5th) business day after the date of enrollment but prior to the first day of class, payment for tuition fee shall be refunded to the student.

b. When notice of cancellation is given after midnight of the fifth business day after the date of enrollment but prior to the first day of class, the school will retain 25% of the cost of full tuition fee.

c. When notice of cancellation is given during the first week of class attendance, the school will retain all payments made up to 50% of the cost of full tuition fee

d. When notice of cancellation is given during the second week of class attendance or 50% of the course schedule, the school will retain the 75% of the cost of full tuition fee

e. When notice of cancellation is given after 50% of the course schedule, the student has to pay the full cost of tuition fee and will not be eligible for refund.

3. Deposits or down payments shall become part of the tuition

4. The school shall mail a written acknowledgement of a student’s cancellation or written withdrawal to the student within 15 calendar days of the postmark date of notification. Such written acknowledgement is not necessary if a refund has been mailed to the student within 15 calendar days.

5. All student refunds shall be made by the school within 30 calendar days from the date of receipt of the student’s cancellation.

6. A student may give notice of cancellation to the school in writing. The unexplained absence of a student from a school for more than 2 school days shall constitute constructive notice of cancellation to the school. For purposes of cancellation the date shall be the last day of attendance.

7. A school may not make refunds which exceed those prescribed in this Section. The school has no refund policy that returns more money to a student than those policies prescribed in this Section. A school shall refund all monies paid to it in any of the following circumstances:

a. The school did not provide the prospective student with a copy of the student’s valid enrollment agreement and a current catalog or bulletin. (can be downloaded from the School website :)

b. The school cancels or discontinues the course of instruction in which the student has enrolled.

NOTICE TO STUDENT

1. Do not sign this agreement before you have read it or if it contains any blank spaces.

2. This agreement is a legally binding instrument and is only binding when the agreement is accepted, signed, and dated by the authorized official of the school or the admissions officer at the school’s principal place of business. Read all pages of this contract before signing.

3. You are entitled to an exact copy of the agreement and any disclosure pages you sign.

4. This agreement and the school catalog constitute the entire agreement between the student and the school.

5. Any changes in this agreement must be made in writing and shall not be binding on either the student or the school unless such changes have been approved in writing by the authorized official of the school and by the student or the student’s parent or guardian. All terms and conditions of the agreement are not subject to amendment or modification by oral agreement.

6. The school does not guarantee the transferability of credits to another school, college, or university. Credits or coursework are not likely to transfer; any decision on the comparability, appropriateness and applicability of credit and whether credit should be accepted is the decision of the receiving institution.

STUDENT ACKNOWLEDGMENTS 

1.  I hereby acknowledge receipt of the school’s catalogue, which contains information describing programs offered, and equipment or supplies provided. The school catalog is included as part of this enrollment agreement and I acknowledge that I have received a copy of this catalog. 

Student Initials ______

2. I have carefully read this enrollment agreement.

Student Initials ______

3. I understand that the school may terminate my enrollment if I fail to comply with attendance, academic, and financial requirements or if I fail to abide by established standards of conduct, as outlined in the school catalog. 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 or credential may be awarded.

Student Initials ______

4. I hereby acknowledge that the school has made available to me all required disclosure information listed under the Consumer Information section of this Enrollment Agreement.

Student Initials______

5. I understand that the school does not guarantee transferability of credit and that in most cases, credits or coursework are not likely to transfer to another institution. 

Student Initials ______

6. I understand that the school does not guarantee job placement to graduates upon program completion.

Student Initials ______

7. I understand that complaints, which cannot be resolved by direct negotiation with the school in accordance to its written grievance policy, may be filed with the Illinois Board of Higher Education, 1 N. Old State Capitol Plaza, Suite 333 Springfield, IL 62701or at http://complaints.ibhe.org or www.ibhe.org.  See detailed process on next page.

Student Initials ______

The student acknowledges receiving a copy of this completed agreement, the school catalog, and written confirmation of acceptance prior to signing this contract. The student by signing this contract acknowledges that he/she has read this contract, understands the terms and conditions, and agrees to the conditions outlined in this contract. It is further understood that this agreement supersedes all prior or contemporaneous verbal or written agreements and may not be modified without the written agreement of the student and the School Official. The student and the school will retain a copy of this agreement. 

___________________________________ /_______________________

Student’s Signature (If Minor) Parent / Guardian Signature   

Admission Date______________ Chief Office Manager Signature_____________  Date________

Complaints

Any student or faculty who has a complaint will be given an opportunity to complete a complaint form and has the right to have their complaint resolved promptly and fairly. Any student or faculty who files a written grievance shall not be subject to punitive action. If a student or faculty has a suggestion or complaint against Chicago Instruction Center for Career Development LLC., or any instructor(s), we recommend that your complaint or suggestion be addressed to the appropriate authority at Chicago Instruction Center for Career Development LLC. You will not in any way be retaliated against or punished for making a suggestion or complaint. Retaliation is prohibited by federal and state law: any evidence of retaliation will be acted upon immediately. More importantly we value your feedback, comments, or suggestions for improvement at Chicago Instruction Center for Career Development LLC. 

It is part of our mission to provide our students with the highest level of education in a professional manner. Please provide specific details of the incident, which prompted your complaint or suggestion, also provide in details the solution or suggestion you recommend. The chain of command is: student and instructor(s) will ideally try to reconcile the issue or complaint, at which point the issue is resolved. However, if the student or faculty is not satisfied with the resolution, you may proceed to the next level of resolution, in which the Chief Managing Officer or Administrator will be involved to achieve the best possible resolution. 

If the following steps are not satisfactory to the student, the student or faculty may proceed in filing a complaint.

Complaints against this school may be registered with the: 

Illinois Board of Higher Education 

1 N. Old State Capitol Plaza, Ste 333 

Springfield, IL 62701 

Verbal instructions on submitting complaints are available by calling IBHE at (217) 782-2551

Online: at http://complaints.ibhe.org or www.ibhe.org