Program Application – SembraSchool

Name(Required)

First Last

Mailing Address(Required)

Street Address Apt Number City State ZIP Code

Email(Required)

Phone(Required)

Date of Birth(Required)

NURSE AIDE I TRAINING PROGRAM

Course Preferred:(Required)

Mornings: 8:30am to 12:30pm, Monday thru Friday (6 Weeks)

Evenings: 6pm to 10pm, Monday thru Friday (6 Weeks)

Weekends: 9am to 3pm, Saturday and Sunday (10 Weeks)

Preferred Start Date:

Tuition and Fees

Item (Must be purchased through SembraSchool)	Cost
Registration fee (Non-refundable)	$150.00
Tuition	$825.00
Textbook (Non-refundable)	$34.00
Uniform (scrubs and ID badge) (Non-refundable)	$30.00
Criminal Background Check (Non-refundable)	$10.00
Total	$1049.00
Discount for Paying in Full (-$50)	$949.00

Refund Policy and Regulations

Refunds will be calculated from the last date of attendance and issued upon receipt of written notice of intent to withdraw to the Program Coordinator or Administrative Manager.
Refunds will be issued under the following circumstances:
- 100% of all monies will be refunded if a student withdraws before the first day of class or if the school cancels the class.
- 75% of tuition will be refunded if the student withdraws within the first 25% of the period of enrollment for the course the student was charged.
  - Please Note: 25% of the course falls on the 8th class day. Students must withdraw prior to day 8 of the class to be eligible for a refund.
  - NO refunds will be issued on registration fee, uniforms, books, or criminal background check fees after the first day of class

Highest Level of Education Completed:(Required)

Have not graduated from high school --> STOP! You cannot enroll yet!

High School or G.E.D

Associates Degree

Bachelor's Degree

Master's Degree or Higher

Do you give consent for a Criminal Background Check(Required)

Yes

Applicant Signature:(Required)

Date(Required)