Vocational Nursing Program REQUIRED GENERAL SCIENCE COURSES

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1 LAST NAME: FIRST NAME: Class Date: Campus: South San Francisco Hayward Class Day/Time: Required General Science Courses: Anatomy & Physiology General Psychology Vocational Nursing Program REQUIRED GENERAL SCIENCE COURSES Student File Checklist (OFFICE USE ONLY) Application for Admission Enrollment Agreement Rules & Regulations RGS Retake Policy Revised Main Campus: 257 Longford Drive Rm# 5, South San Francisco, CA 94080, Tel# (650) ; Fax# (650) Branch Location: Hesperian Blvd. Suite A, Hayward, CA 94541, Tel# (510) ; Fax# (510) w w w. n c p c o l l e g e o f n u r s i n g. edu

2 Page 1 of 2 General Application for Admission VOCATIONAL NURSING PROGRAM South San Francisco Campus General Psychology Hayward Campus Anatomy and Physiology Intended VN date of enrollment / cohort number: Name: Last First Middle Initial Current Address: Street City State Zip Permanent Address: Street City State Zip Phone Day ( ) Phone Evening ( ) Date of Birth: Social Security # Address: Driver s License or ID #: Gender: Male / Female (circle one) Ethnicity: Hispanic/Latino American Indian/Alaskan Native Asian African-American Caucasian Native Hawaiian/Pacific Islander Other Emergency contacts (list 2 people who are related to you) 1. Name: Relationship: Address: Phone ( ) Street City State Zip 2. Name: Relationship: Address: Phone ( ) Street City State Zip Revised 4/08, 7/09, 10/09, 9/10, 2/12,11/12, 2/21/13

3 Page 2 of 2 Emergency contacts (list 2 people who are NOT related to you) 3. Name: Relationship: Address: Phone ( ) Street City State Zip 4. Name: Relationship: Address: Phone ( ) Street City State Zip Educational Background (Highest Education Attained) Attended High School High School Diploma/GED Some College Associate/Bachelor s Degree Post College Work Experience (please list most recent experience first) Year Job Title Occupation/Employer Duties & Responsibilities How did you hear about NCP? Friends or Family (please list name) NCP Student/Graduate TV Ad (channel #) Internet (specific site): Yahoo Google Facebook Twitter Newspaper (name) Faxed/Posted Flyer at Nursing Facility (please list name of facility): Career Centers Adult School Ad Veteran s Office Other (please be specific): Please list other programs you have attended at NCP I certify that the above information is true and correct to the best of my knowledge. Date: Signature of Applicant: Revised 4/08, 7/09, 10/09, 9/10, 2/12,11/12, 2/21/13

4 Page 1 of 7 REQUIRED GENERAL SCIENCE COURSES Enrollment agreement South San Francisco Campus Hayward General Psychology Anatomy and Physiology Name: Street Address: City: State: Zip: Tel: ( ) Mobile: ( ) Total Clock Hours of Instruction: Program Length (in months): 54 hours 1.5 months (6 weeks) Specific Times of Class Attendance: South San Francisco Campus: Classes are held every Monday, Wednesday and Friday, from 5:00PM to 8:00PM for classroom instruction. Hayward Campus: Classes are held every Monday, Wednesday and Thursday, from 5:00PM to 8:00PM for classroom instruction Type of Document Awarded Upon Completion: Final Grade Report RGS Course Start Date: Completion Date: For One of The Two RGS Courses Offered: FEES AND CHARGES Application Fee (non-refundable) $ Tuition Fee STRF 2.50 Textbooks and materials Total Course Fee for 1 Course $ * *Books and Study Guide are not returnable for refund. Tuition and Program fees are subject to change but will not affect students who are already in the program

5 Page 2 of 7 PAYMENT METHOD AND TERMS OF PAYMENT Payment for each required General Science Course Fee is due on the first day of class. If full payment is not received on this date, the student will not be allowed to start class, unless prior payment arrangement has been made with the school s Campus Manager. Failure to pay any balances due will prevent the student from taking the final examination and/or getting a final grade for each particular course. PAYMENT SCHEDULE SUBJECT General Psychology Anatomy & Physiology DUE DATE (due Upon Submission of Application) (due Upon Submission of Application) AMOUNT DUE $ $ AMOUNT PAID FORM OF PAYMENT RECEIPT NUMBER DATE OF PAYMENT TOTAL FEES AND CHARGES THE TOTAL AMOUNT THAT THE STUDENT IS OBLIGATED TO PAY FOR THE PROGRAM OF INSTRUCTION, AND ALL OTHER FEES AND CHARGES IS $ The undersigned student promises to pay the course fee in full on or before first day of class unless other payment arrangements have been made with the school prior to the first day of class. The student understands that the total course fee must be completely paid before the student can be cleared of its financial obligation with NCP College of Nursing. Any default of payment is in violation of this enrollment agreement and will be a basis for dismissal from the course. The student also understands that any RETURNED CHECKS will be subject to an additional $35.00 processing fee (per check) payable to NCP. Acceptable replacements for any returned check and subsequent installment payments will only be in CASH or Money Order or credit card, until the tuition fee balance is paid in full.. Any payments received after the due date will incur a late fee of 5% that is added to the student s account. NOTICE OF TRANSFERABILITY OF CREDITS AND CREDENTIALS EARNED AT OUR INSTITUTION The transferability of credits/degree you earn at NCP College is at the complete discretion of an institution to which you may seek to transfer. Acceptance of the certificate is also at the complete discretion of the institution to which you may seek to transfer. If the certificate that you earn at this institution is not accepted at the institution to which you seek to transfer, you may be required to repeat some or all of your coursework at that institution. For this reason you should make certain that your attendance at this institution will meet your educational goals. This may include contacting an institution to which you may seek to transfer after attending NCP College of Nursing to determine if your certificate will transfer. GROUNDS FOR CANCELLATION/TERMINATION OF ENROLLMENT BY THE SCHOOL The school will cancel or terminate the Enrollment Agreement with a student if the student s actions or decisions result in any of the following: Failure to maintain satisfactory academic progress. Failure to maintain satisfactory attendance. Failure to comply with the policy relating to ethical behavior. Failure to meet financial obligations. Violation of any of the conditions as set forth and agreed to in the Enrollment Agreement.

6 Page 3 of 7 STUDENT S RIGHT TO CANCEL You have the right to cancel the Enrollment Agreement and obtain a refund of charges paid without any penalty or obligations, through attendance at the first class session or the seventh calendar day after enrollment, whichever is later. Cancellation can occur no later than. DATE PROCEDURES FOR CANCELLATION/TERMINATION BY THE STUDENT Cancellation shall occur when the student gives written notice of cancellation to the school at the address indicated below: NCP Career College-Hayward NCP Career College-South San Francisco Hesperian Blvd., Suite A 257 Longford Drive, Room 5 Hayward, CA South San Francisco, CA The written notice of cancellation, if mailed is effective when deposited in the mail properly addressed with postage prepaid. For the purpose of determining the time within which a student may cancel the agreement a day is defined as a day on which the student is scheduled to attend a class session. Refunds and fee obligations are determined on the basis of the student s last day of attendance in class. For documentation purposes, the student must put his/her withdrawal or cancellation request in writing and complete the withdrawal process which includes the notification of the Program Director. The processing of all applicable refunds, however, is not contingent upon the student s written request for withdrawal. (See Refund Policy for more details). If the student has already attended classes, he/she must inform the instructor(s) first to determine the final grade(s) to be entered on his/her transcript. Next, the student notifies the Program Director in writing of his/her desire to cancel/terminate the enrollment. The Program Director will discuss the student s option for a leave of absence and factors that may affect his/her re-admission. The withdrawal letter may be hand-delivered or mailed to: NCP Career College-Hayward NCP Career College, SSF Campus Hesperian Blvd., Suite A 257 Longford Drive, Room 5 Hayward, CA South San Francisco, CA Attn: VN Program Director Attn: VN Program Director Verbal or telephone withdrawals will not be accepted. Then, the Student and Career Services Coordinator and Campus Manager are notified by the Program Director of the cancellation or termination. The Campus Manager explains to the student his/her fee obligations and/or availability of a refund. Then the Office Manager endorses the student s request to the Accounting Office for the processing of a refund. Finally, the student is issued the refund based on his/her last day of attendance within thirty days.

7 Page 4 of 7 REFUND POLICY All monies paid by an applicant must be refunded if requested within the cancellation period. An applicant requesting cancellation after the cancellation period stated in the enrollment agreement and making an initial payment, but prior to entering the school, is entitled to a refund of all monies paid minus the registration fee. {( IV A) (14) (a-b) Substantive Standards, Standards of Accreditation, Accrediting Commission of Career Schools and Colleges}. A student is entitled to a 100 percent refund of the amount paid for institutional charges, less a reasonable deposit or application fee not to exceed two hundred fifty dollars ($250), if notice of cancellation is made through attendance at the first class session, or the seventh class day after enrollment, whichever is later. {California Private Postsecondary Education Act 2009 (Article 13) (94920) (b)} If a student withdraws from a course or is terminated for cause after the cancellation period, the student will receive a refund prorated from the last date of attendance not equal to or exceeding 60% attended by the student. The school will automatically initiate a withdrawal for a student who has not notified the school of his/her withdrawal or attended school for ten consecutive days and will issue a refund within 30 days prorated from the last date of attendance not equal to or exceeding 60%. The student will be considered withdrawn from the program. A written notification of withdrawal is not a requirement for payment of the refund {( I (D) (5) Substantive Standards, Standards of Accreditation, Accrediting Commission of Career Schools and Colleges} EXAMPLES OF CALCULATION OF REFUNDS: 1. If a student withdraws after the completion of 10% of the course of instruction, NCP will refund 90% of the total charges for the course less the application fee, books and other training materials and Student Tuition Recovery Fund. If a full payment is received prior to withdrawal, calculation of the refund is computed as follows: Tuition Fee Package & Application Fee $ Less: Application Fee (non-refundable) $ Books & Materials $ STRF $ 2.50 Balance Remaining $ Therefore: 90% x $ = $ Refund Due 2. If a student withdraws after completion of 25% of the course, NCP will refund 75% of the total charge for the course less the application fee, books and other training materials and Student Tuition Recovery Fund. 3. If a student withdraws after completion of up to 60% of the course, NCP will refund 40% of the total charge for the course less application fee, books and other training materials and Student Tuition Recovery Fund. 4. No refunds will be given if a student has attended more than 60% of the course. Books, other training materials, and uniforms are not refundable. Fees paid with personal check(s) will need to be cleared first before refunds can be processed. The check clearance usually takes thirty days. The prorated calculation of the refund will start from the last date of the student s attendance. The school will issue the student a receipt for any money collected or refunded. NCP will also refund any monies received from third parties (e.g. Sallie Mae, WIA, NOVA, etc.) on behalf of the student and according to the agreement(s) each party made with the student.

8 Page 5 of 7 If the student obtains a loan to pay for an educational program, the student will have the responsibility to repay the full amount of the loan plus interest, less the amount of any refund. If the student is eligible for a loan guaranteed by the federal or state government and the student defaults on the loan, both of the following may occur: (1) The federal or state government or a loan guarantee agency may take action against the student, including applying any income tax refund to which the person is entitled to reduce the balance owed on the loan. (2) The student may not be eligible for any other federal student financial aid at another institution or other government assistance until the loan is repaid. NCP reserves the right to cancel a class due to insufficient enrollment. If this occurs, the student will be issued a full refund of all monies paid unless the student elects to apply all monies paid to the next scheduled class start date. In such a case, the student is issued a credit memo stating that he/she has the money in his account with the school. Withdraw / Refund Policy NCP College complies with the requirements of the California Administrative Code, Section Under this code, the minimum refund allowed shall be as follows: Percent of Attendance Time Up to 10% if class attendance hours: Over 10%-25% of class attendance hours: Over 25%-60% of class attendance hours: Over 60% of class attendance hours: Maximum Amount of Refund/Grade 90% // W 75% // W 60% // W NO REFUND and a final grade of F THE STUDENT TUITION RECOVERY FUND (STRF) The state of California created the Student Tuition Recovery Fund (STRF) to relieve or mitigate economic losses suffered by California residents who were attending schools approved by registered to offer Short-Team Career Training with the Bureau for Private Postsecondary & Vocational Education (Bureau). Student is responsible for paying that state assessment amount for the Student Tuition Recovery Fund. Student Tuition Recovery Fund You must pay the state-imposed fee for the Student Tuition Recovery Fund (STRF) if all the following applies to you: 1. You are a student in an educational program, who is a California resident, or are enrolled in a residency program, and prepay all of part of your tuition either by cash, guaranteed student loans, or personal loans, and 2. Your total charges are not paid by any third-party payer such as an employer, government program or other payer unless you have a separate agreement to repay the third party. You are not eligible for protection from the STRF and you are not required to pay the STRF assessment if either of the following applies: 1. You are not a California resident, or are not enrolled in a residency program, or 2. Your total charges are paid by a third party, such as an employer, government program or other payer, and you have no separate agreement to repay the third party. You may be eligible for the STRF if you are a California resident, prepaid tuition, paid the STRF fee, and suffered an economic loss as a result of any of the following: 1. The school closed before the course was completed. 2. The school s failure to pay refunds or charges on behalf of a student to a third party for license fees or any other purpose, or to provide equipment or materials for which a charge was collected within 180 days before the closure of the school.

9 Page 6 of 7 3. School s failure to pay or reimburse loan proceeds under a federally-guaranteed student loan program as required by law, or to pay or reimburse proceeds received by the school prior to closure in excess of tuition and other costs. 4. The school breached or anticipatory breach of the agreement for the course of instruction. 5. There was a decline in the quality of the course of the agreement for the course of instruction within 30 days prior to closure, period of decline determined by the Bureau. 6. The school committed fraud during the recruitment or enrollment in the program participation of the student.. You may also be eligible for STRF if you were a student that was unable to collect a court judgment rendered against the school for violation of the Private Postsecondary and Vocational Education Reform Act of DISCLAIMER OF EMPLOYMENT GUARANTEE Although the students are given career and employment advisements and assistance, the school does not guarantee their employment once they have successfully completed their training CONDITIONAL ITEMS DELAY OF SCHEDULED STARTING DATE NCP reserves the right to cancel a class due to insufficient enrollment. The student is given the option (1) to enroll in a class available in the branch campus, or (2) to wait until the next rotation. If the student chooses neither, he/she will be issued a full refund of all monies paid unless the student elects to apply all monies paid to the next scheduled class start date. In such a case, the student is issued a credit memo stating that he/she has the money in his account. CHANGES IN PROGRAM CONTENT AND MATERIALS NCP reserves the right to change or modify the program contents, equipment, or materials as it deems necessary. Such changes may be necessary to keep pace with technological advances and to improve the schools learning resources. Such changes will not diminish the essentials or content of any program or result in any additional charges to the student. SPECIAL GRADUATION REQUIREMENTS A student must meet the following requirements to qualify for graduation and receive the Certificate of Completion of the Vocational Nursing Program: Achieve a cumulative grade of C or higher in theory classes and a passing grade (P) in practicum Attend at least 90% of the required clock hours of the program Comply with the policy on ethical behavior Satisfy all financial obligations to the school Complete all course requirements (tests, assignments, projects, attendance make-up, remediation) Complete the program within 1.5 times its normal length. No student will be allowed to join the commencement exercises on graduation without having completed all of the above.

10 Page 7 of 7 ADJUSTMENT OF TUITION RATES The school reserves the right to adjust tuition rates prior to the start of any program for new enrollees. There will be no tuition rate adjustments after a program has started. The tuition rate adjustments for new enrollees will not affect the students who are already in the program. Any questions or problems concerning the enrollment agreement that have not been satisfactory answered or resolved by the institution should be directed to the Bureau for Private Postsecondary Education at 2535 Capitol Oaks Dr., Ste. 400, Sacramento, CA (916) A student or any member of the public may file a complaint about this institution with the Bureau for Private Postsecondary Education by calling (888) toll-free or by completing a complaint form, which can be obtained on the bureau's internet web site Language Information If English is not the student s primary language, and the student is unable to understand the terms and conditions of the enrollment agreement, the student shall have the right to obtain a clear explanation of the terms and conditions and cancellation and refund policies in his or her primary language. If the recruitment leading to enrollment was conducted in a language other than English, the enrollment agreement, disclosures, and statements shall be in that language. STUDENT ACKNOWLEDGEMENT PRIOR TO SIGNING THIS ENROLLMENT AGREEMENT, YOU MUST BE GIVEN A CATALOG OR BROCHURE AND A SCHOOL PERFORMANCE FACT SHEET, WHICH YOU ARE ENCOURAGED TO REVIEW PRIOR TO SIGNING THIS AGREEMENT. THESE DOCUMENTS CONTAIN IMPORTANT POLICIES AND PERFORMANCE DATA FOR THIS INSTITUTION. THIS INSTITUTION IS REQUIRED TO HAVE YOU SIGN AND DATE THE INFORMATION INCLUDED IN THE SCHOOL PERFORMANCE FACT SHEET RELATING TO COMPLETION RATES, PLACEMENT RATES, LICENSE EXAMINATION PASSAGE RATES, AND SALARIES OR WAGES, PRIOR TO SIGNING THIS AGREEMENT. I CERTIFY THAT I HAVE RECEIVED THE CATALOG, SCHOOL PERFORMANCE FACT SHEET, AND INFORMATION REGARDING COMPLETION RATES, PLACEMENT RATES, LICENSE EXAMINATION PASSAGE RATES, AND SALARY OR WAGE INFORMATION INCLUDED IN THE SCHOOL PERFORMANCE FACT SHEET, AND HAVE SIGNED, INITIALED, AND DATED THE INFORMATION PROVIDED IN THE SCHOOL PERFORMANCE FACT SHEET. I UNDERSTAND THAT THIS IS A LEGALLY BINDING CONTRACT. MY SIGNATURE BELOW CERTIFIES THAT I HAVE READ, UNDERSTOOD, AND AGREED TO MY RIGHTS AND RESPONSIBILITIES, AND THAT THE INSTITUTION S CANCELLATION AND REFUND POLICIES HAVE BEEN CLEARLY EXPLAINED TO ME. THE ENROLLMENT AGREEMENT IS LEGALLY BINDING WHEN SIGNED BY STUDENT AND ACCEPTED BY THE INSTITUTION. Enrollment Agreement effective from date of signature through completion of the program CHARGES ESTIMATED TOTAL CHARGES - $ TOTAL CHARGES FOR THE CURRENT PERIOD OF ATTENDANCE- $ TOTAL CHARGES DUE UPON ENROLLMENT - $ Remaining balance due on or before first day of class. Signature of Student Date Signature of Campus Manager Date

11 Page 1 of 2 RULES AND REGULATIONS Any violation of the rules and regulations of the school shall be subject to review by Administration to determine corrective action. Violations may be ground for suspension or dismissal. Any student who finds it necessary to withdraw must notify the Program Director promptly of the intent to discontinue classes. Students must state full reasons explicitly in writing and must complete the Student Withdrawal Form. ATTENDANCE Every training program requires that attendance is mandatory. Students must be in class as scheduled in order to meet the behavioral objectives and the required training hour s acquisition of knowledge and skills to be safe and competent health care providers. 1. Absence Regular attendance and punctuality will help students develop good attendance habits required for a successful career. To maintain satisfactory attendance, students must be present for 90 percent of the clock hours allotted for the course. Therefore, if a student falls below 90 percent attendance of the course, that student will be advised to withdraw or will be administratively withdrawn from the program. 2. Tardiness is a disruption of the learning environment and is highly discouraged. A student who arrives in theory class more than 10 minutes late based on the classroom clock is considered tardy. Persistent tardiness defined as tardiness of more than two times is considered an unexcused absence. Students are encouraged to join the class even if marked absent for the day to maximize learning at the discretion of the instructor. However, accrued absences will be considered in determining satisfactory attendance. 3. Cutting Classes - Cutting of classes is considered as an absence. If the student is absent for four consecutive classes and the student remains unresponsive to communication efforts- the Campus Manager will process an administrative withdrawal and the final grade on the transcript will be an F. 4. Make-Up Work - Students will be required to make-up all assignments, exams, or other work missed as the result of an absence. Arrangements to take a missed exam must be made with the instructor within two days of returning from an absence. Remediation options may be available to students who are unable to meet academic course requirements. Acceptable methods of make-up include: Theory: Case studies, independent study, written examination, attendance seminars or work shops, and research reports. 5. Withdrawal Written requests to withdraw from the program must be submitted to the Campus Manager for processing. If 60% of the program has been completed, then as stated in the enrollment agreement- no refund shall exist and the final grade for the course will be a F. Those withdrawing before 60% of the hours have been completed will have a W on their transcript. Revised 04/28/2011; 11/2012 *For the following Programs: Anatomy & Physiology and General Psychology

12 Page 2 of 2 PERSONAL CONDUCT 1. Smoking is not allowed anywhere on school premises including the parking lot. 2. Drinking and eating is not allowed in the classroom UNLESS in specific, designated areas. 3. UNDER NO CIRCUMSTANCES will any student under the influence or in possession of alcohol, drugs or any controlled substance be allowed to stay in school. 4. Students must be courteous and pleasant at all times and respect the tenants of the school building and the residents in the neighborhood. Unprofessional behavior, noise, rowdiness and any other acts reported by tenants or neighbors shall be brought to the attention of the student and may result in immediate disciplinary action. 5. All school facilities must be kept clean and in proper order when used by students. This includes bathrooms, computer lab, skills lab, classrooms, and student lounge. 6. For Hayward Campus: Parking spaces are available for student parking except for those that are marked for other businesses and for faculty. Spaces are limited; please carpool whenever possible. For South San Francisco Campus: Parking lot is available for student parking except for those that are marked for faculty parking only. Please observe 25 mph speed limit. 7. Students are not allowed to carry firearms, deadly weapons or objects that can be used as weapons. Liquor, controlled substances or any items considered dangerous or volatile must not be carried in the classroom areas. 8. Academic dishonesty or misrepresentation in any form will be dealt with by an administrative withdrawal from the Program Director. Student s Signature NCP Representative Date Date Revised 04/28/2011; 11/2012 *For the following Programs: Anatomy & Physiology and General Psychology

13 REQUIRED GENERAL SCIENCE COURSE RE-TAKE AND RE-ADMISSION POLICY NCP College of Nursing Required General Science Course re-takes policy states: 1. There will be a fee associated with re-taking any portion of a Required General Science Course. 2. Should any student withdraw or be asked to withdraw from the program by the NCP administration, all fees will apply upon re-admittance into the program and will be treated as a new enrollment. 3. If a student is re-admitted to the Required General Science Course a $75 application fee would also apply. Student s Signature Date Main Campus: 257 Longford Drive Rm# 5, South San Francisco, CA 94080, Tel# (650) ; Fax# (650) Branch Location: Hesperian Blvd. Suite A, Hayward, CA 94541, Tel# (510) ; Fax# (510)

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