Student Name*

Date*

D.O.B*

Address*

Phone Number*

S.S. Number*

Email Address*

Emergency Contact*

Emergency Number*

Which classes are you enrolling in?*
Day ClassEvening Class

Entrance Term*
SummerFallWinterSpring

Payment:

All tuition and fees are payable for one quarter, semester or school term only. Payment is due prior to the start of classes each term. Payment plans are available. Subject to change.

*PCHS CAN Alumni gets a $500 discount on tuition

Tuition and fee charges are subject to change at the school’s discretion. Any tuition or fee increases will become effective for the school term following student notification of the increase. Premier Choice Health Services reserves the right to amend this policy at any time.

Cancellation and Settlement policy

This enrollment agreement may be canceled within five calendar days after the date of signing provided that the school is notified of the cancellation in writing. If such cancellation is made, the school will promptly refund in full all tuition and fees paid pursuant to the enrollment agreement and the refund shall be made no later then thirty days after cancellation. This provision shall not apply if the student has already started academic classes.

Refund Policy

If the student is not accepted into the training program, all monies paid by the student shall be refunded. Refunds for books, supplies and consumable fees shall be made in accordance with Ohio Administrative Code section 3332-1-10.1. There is one (1) academic term for this program that is 200 clock hours in length. Refunds for tuition and refundable fees shall be made in accordance with following provisions as established by Ohio Administrative Code section 3332-1-10:

I affirm that the information I have provided on this application, including responses to any other information that I have submitted or will submit to Premier Choice Health Services in connection with the admission, is complete and accurate and is my own work. I understand that submission of incomplete or inaccurate information is sufficient cause for revocation of admission or enrollment.

I agree to the statement above

I have read the student policy agreement