REGISTER

First Name: Last Name: Date of Birth: / /

Address: Apt: City: State: Zipcode:

Home Phone: Cell: Email:

Emergency Contact: Home Phone: Cell:

Alternate Contact: Home Phone: Cell:

Training Program Options:
Choose Day or Night Class

Day Class (8:00am - 11:30am) Night Class (5:00pm - 8:30pm)

AWS Entry Welder – Level 1 Program / $4032
EWP Books and Equipment / $350
Advanced Welder - Level 2 Program / $5376
AWP Books and Equipment / $600

Payment Options:
(Choose One)

Cash Check Credit Card
Other:
Payment Plan: Weekly Bi-Weekly

Cancellation and Refund Policy
Students may cancel your enrollment at any time. You are entitled to a full refund if you cancel your enrollment within three (3) days after signing the enrollment agreement and making an initial payment. If you cancel your enrollment more than three (3) days after signing an enrollment agreement and making an initial payment, but prior to entering the school you are entitled to a full refund which will be mailed within thirty (30) days of notice of withdrawal, minus a $100 termination fee. If you cancel your enrollment once Module has commenced for any reason other than family emergency, illness, or accident; which makes it impractical to complete the program; and have completed up to 55% of the program, a Pro Rated refund computed on the number of hours completed to the total program hours will be returned to you. Cancellation occurring after completing more than 55% of the program will result in no refund of tuition paid. Termination date for refund computation purposes is the last date of actual attendance or date of official written withdrawal request whichever occurs first. Refunds will be issued by check within thirty (30) days of established termination date.

By checking this box I agree to the terms and conditions as stated above. (Required to register)