Withdrawal Form | SembraSchool

Student Withdrawal Form

Name(Required)

First Last

Address(Required)

City State ZIP Code

Email(Required)

Phone(Required)

Last 4 digits of your social security number(Required)

Date of Birth(Required)

Program you are withdrawing from(Required)

Nurse Aide I

MedTech

Your course start date

Last date you attended class

Refund Policy

Refunds will be calculated from the date of formal withdrawal from the program. Students must provide written notice of intent to withdraw to the Program Coordinator or Administrative Manager.

NO refunds will be issued on the following:

Registration fee
Uniforms
Books
Criminal background check fees

Refunds will be issued on tuition under the following circumstances:

100% refund if a student withdraws before the first day of class or if the school cancels the class.
75% refund if the student withdraws within the first 25% of the period of enrollment for the course the student was charged.
Student must withdraw prior to day 8 of the course.

I understand and agree to the refund policy.(Required)

Yes

Signature(Required)