Refresher 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 REFRESHER PROGRAM

Preferred Start Date:

Tuition and Fees

Item (Must be purchased through SembraSchool)	Cost
Registration fee (Non-refundable)	$100.00
Tuition	$466.00
Textbook (Non-refundable)	$34.00
Total	$600.00
Discount for Paying in Full (-$50)	$550.00

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 3rd class day. Students must withdraw prior to day 3 of the class to be eligible for a refund.
  - NO refunds will be issued on registration fee or books after the first day of class.

Which of the following situations apply to you?(Required)

Have an expired NC Nurse Aide I Registry number (Enter registry number below)

Completed a prior state-approved NA-I training program (Must submit transcripts)

Have military healthcare training equivalent to NC NA-I training

Last 4 digits of social security number(Required)

If you have transcripts from a prior CNA school or military training, upload it here:

Max. file size: 50 MB.

Applicant Signature:(Required)

Date(Required)