Eagle EMS Spring 2013 EMT-B Course Registration

Instructions, please read completely!: Please read the following application information, then fill out the following Google Document Form, which will serve as your course application. Because the weekdays of the class have not yet been determined, we will not accept deposits until the days have been finalized. Based on what dates the majority of students are available, a determination of what days the class will run will be made as soon as possible. At that point, an email will be sent to all students asking them to complete their application by paying their deposit and course cost. Please register on EMS Academy's website here: http://emsacademy.biz/Home/tabid/238/ctl/Register/Default.aspx Please pay for the course at the proper time here: http://www.emsacademy.biz/OnlinePayments/tabid/280/signupType/plan/Default.aspx Program Fee: All students are responsible for paying a $150.00 nonrefundable deposit to go along with their application. If your deposit is not received by January 21st, the registration deadline, you will forfeit your spot in the class. Seats are filled in the order that deposits are received. If you are not interested in tuition financing, the remaining $850.00 is due by the first day of class. If you fail to pay your fee on the first day of class, you will forfeit your seat. Your text book fee ($125.00) is included in total fee and is also non-refundable. State Certification Application and State Written Exam fees are not included in the “total fee” and are the responsibility of the student. These fee’s are payable to the State and exam company at the completion of the program. Tuition Financing Agreement: 1) EMS Academy offers this option to students as a courtesy. Credit checks ARE NOT required to qualify for Tuition Financing. 2) I understand that by applying for financing, I agree to all of the following conditions: a. A payment of $150.00 must accompany your application. b. A payment of $350.00 is due the first night of class. Total payments received by the first night of class should equal $450.00. c. The second payment is due on the 1st class of week two and weekly thereafter. Tuition must be paid in full by week 4. d. Weekly payments of $150.00 will be due on the 1st class of each week. e. Financing fee of $50.00 is in addition to the regular (non-financed) tuition. * (May be waived if full payment is received by week 4 and the student has not been late or missed a payment.) f. Delinquent finance payments will result in holding of class grades until payment is made. g. If I fail to make tuition payments, I will pay all EMS Academy-associated costs incurred in the effort to collect the tuition (including but not limited to bank fees, court costs, attorney fees, lost wages, etc.), whether course was completed or not. 1. Upon completion of the EMT program, if tuition has not been paid, I will not have successfully completed the program, and my application for the state exam will not be forwarded until all tuition & fees have been paid in full. Refund Policy: Refund Policy: Full payment is required by the start of the first class. If you withdraw from the program, the financing agreement does not waive this responsibility. Your application fee, initial deposit, and any text book fees are non-refundable. 1. A student will receive: a. 100% refund up to 14 days prior to the start of lesson #1, less fees* b. 50% refund if the student withdraws 7 day prior to the start of lesson #1 as described above, less fees* c. 25% refund within 7 days of the start of the 1st class, less fees* d. Once the program begins all refunds will be made within thirty days e. Your application fee and other non-tuition fees are non-refundable Financing students: EMS Academy’s approval for you to finance your tuition does not waive your responsibility of paying in full should you withdraw from the program. The tuition is due by the first lesson for ALL students and only those approved for financing may make payments beyond the first night. If you withdraw from the program at any time, you are no longer considered to be a financing student, and your balance becomes due in full immediately. The refund policy is the same for the financing student as it is for the non-financing student. Student Loans: If you are approved for a Student Loan and disbursements have been made to EMS Academy and you decide to withdraw at anytime for any reason, you will receive a prorated refund for the unused portion which will be returned to the lending institution. Affirmation: By completing this Google Document Form, I certify that the information provided in this application is correct and complete. I understand that omission or falsification of information is grounds for exclusion and dismissal. If accepted into the program, I agree to meet all entrance requirements and to abide by the letter and spirit of the rules, regulations, and procedures of EMS Academy. By signing below I acknowledge that I have read this application in its entirety and understand and agree to meet any and all requirements as described in this document. Disclaimer: This form is secure and no information will be shared with anyone outside of EMS Academy and the Education Department of Eagle EMS of Boston College. No information submitted to this form will be used for any other purpose than for registration of students for EMS Academy's spring EMT-Basic course at Boston College. Once registration is complete, all electronic information submitted to this Google Document Form will be removed to ensure safety and privacy. All information is kept private and is protected, but Eagle EMS of Boston College, Boston College, and EMS Academy are not responsible for any information obtained by unauthorized parties. If you have any questions, please contact EagleEMSAdvEd@gmail.com or lori@emsacademy.biz. All students: A $150 deposit is due by the start of the class and can be paid through EMS Academy's website. Non-financing students: The balance of $850.00 is due on the first night. Financing students must pay $300.00 on the first night and weekly payments of $150.00 thereafter. Make Check or Money Orders Payable to: EMS Academy
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