Basic Nursing Assistant Training Program #0932 Enrollment Agreement

Basic Nursing Assistant Training Program #0932 Enrollment Agreement 2040 River Oaks Drive (East 159 th ) Calumet City Illinois, 60409 STUDENT INFORMATION Name: Address: Program: Program Start Date: Number of Weeks: Class Instruction Days: Date: Phone: D.O.B. Program End Date: Morning class/evening class (circle one) Clinical Instruction Days: Program Location: This enrollment agreement is a legally binding instrument when signed by student and accepted by school. This enrollment agreement will specify the legal obligations of both CJ Woods Foundation of Hope (CJW) and. The current amount $ has been applied toward the cost of tuition, books, lab fees, and a one time only (non-refundable) processing fee. There still remains a balance of $ which must be paid in full by date. Until the balance is paid in full by the date listed the student will not be allowed to have paperwork submitted for written competency examination. Personal checks, money orders, cashiers check will be accepted as forms of payment. 1

The itemized description of services provided by CJW and the cost of such services are listed below: COST OF SERVICES Any deposits or down payments shall become part of the tuition. Description Code Timeframe Program Cost Days Time Clinical Location Instructor Nurse Assistant 0330111 6 wks $770.00 M-T-W (S) 9:00 a.m.- 1:30 p.m. TBA Woods M-T-W (S) 5:00 pm - 9:30pm Service Cost Tuition 500.00 Books (Rental Fee) 20.00 Lab Fee 100.00 Registration Fee(included in cost of tuition if course is taken) 150.00 One Time Only NON-REFUNDABLE TOTAL 770.00 2

Name and Description of Course: CJ Woods Foundation of Hope was formed to assist with the career hopes and goals of individuals, groups and organization which have a goal to build a more skilled workforce by strengthening education and job training. We will educate and train individuals so that they can meet the demand and needs of businesses. As an entry level practitioner the graduate will help to fill the health care needs of the community. Our goal is to help reduce the current and projected nurses aide shortage and prepare workers to enter into the workforce with confidence in their technical skills. The program will graduate individuals who demonstrate academic preparation and clinical competence in basic nursing assistance, making them eligible for the certification examination as a nursing assistant in the State of Illinois. The Basic Nursing Assistant Training Program provides 120 hours of training which consists of basic knowledge and understanding of principles and procedures of nursing care. The mandatory 120 hours required by the State of Illinois consists of 80 hours theory and 40 hours clinical. The education and training is obtained through 6 weeks of lecture, skills laboratory, and 5 weeks of supervised clinical experiences at a healthcare facility The schools projected student to teacher ratio for classroom and laboratory instruction is 10:1. In the event there are more than 10 students enrolled in a class, the theory can be taught by one instructor, but laboratory instructors and clinical instructors will maintain a ratio of 10:1 at all times. Additional qualified clinical instructors will be present for student ratios greater than 10 for clinical classes. 3

Refund Policy The student has up until the first day of class to deliver a written request to cancel the course. This request must be given directly to an administrator of CJW. The administrator will give to the student a receipt for the request to cancel the course providing a signature and date of the cancellation request. Refunds will be granted as such: 1. Schools shall, when a student gives written notice of cancellation, provide a refund in the amount of at least the following: a. When notice of cancellation is given before midnight of the fifth business day after the date of enrollment but prior to the first day of class, all application-registration fees, tuition, and any other charges shall be refunded to the student; b. When notice of cancellation is given after midnight of the fifth business day following acceptance but prior to the close of business on the student s first day of class attendance, the school may retain no more than the application-registration fee which may not exceed $150.00 or 50% of the cost of tuition, whichever is less; c. When notice of cancellation is given after the student s completion of the first day of class attendance, but prior to the student s completion of 5% of the course of instruction, the school may retain the application-registration fee, an amount not to exceed 10% of the tuition and other instructional charges or $300, whichever is less, and, subject to the limitations of paragraph 12 of this section, the cost of any books or mayerials which have been provided by the school. d.the school may retain an amount computed prorate by days in class plus 10% of tuition and other instructional charges up to 60% of the course of instruction. When the student has completed in excess of 60% of the course of instruction, the school may retain the application/registration fee and the entire tuition and other charges. c. A student, who on personal initiative and without solicitation enrolls, starts, and completes a course of instruction before midnight of the fifth business day after the enrollment agreement is signed, is not subject to the cancellation provisions of this section; d. Applicants not accepted by the school shall receive a refund of all tuition and fees paid within 30 calendar days after the determination of non-acceptance is made. 4

e. Application-registration fees shall be chargeable at initial enrollment and shall not exceed $150 or 50% of the cost of tuition, whichever is less. f. Depoits or down payments shall become part of the tuition. g. The school shall mail a written acknowledgement of a student s cancellation or written withdrawal to the student within 15 calendar days of the postmark date of notification. Such written acknowledgement is not necessary if a refund has been mailed to the student within 15 calendar days. h. All student refunds shall be made by the school within 30 calendar days from the date of receipt of the student s cancellation. i. A student may give notice of cancellation to the school in writing. The unexplained absence of a student from school for more than 15 school days shall constitute constructive notice of cancellation to CJW. For purposes of cancellation the date shall be the last day of attendance. j. The school shall refund all monies paid to it in any of the following circumstances: 1. the school did not provide the prospective student with a copy of the student's valid enrollment agreement and a current catalog or bulletin; 2. the school cancels or discontinues the course of instruction in which the student has enrolled; 3. the school fails to conduct classes on days or times scheduled, detrimentally affecting the student. k. A school must refund any book and materials fees when: 1. the book and materials are returned to the school unmarked; and 2. the student has provided the school with a notice of cancellation 5

NOTICE TO THE BUYER 1. Do not sign this agreement before you have read it or if it contains any blank spaces. 2. This agreement is a legally binding instrument. All pages of the contract are binding. Please read all pages before signing. 3. You are entitled to receive one copy of the agreement you sign and any information disclosure pages presented by the school. 4. Under the law you have the right, among others, to pay the full amount due. 5. This agreement will be binding only when the agreement is accepted, signed and dated by the authorized official of the school. 6. By signing this agreement you acknowledge that you have received a current copy of the school s catalog. 7. Any changes in this enrollment agreement shall not be binding on either the student or the school unless such changes have been approved in writing by the authorized official of the school and by the student or the student s parent or guardian if the student is a minor. 8. If the student is a minor only the parent of the student or guardian can submit signatures on all required documents before enrollment into the school. 9. Terms and conditions of the agreement are not subject to amendment or modification by oral agreement. 10. This agreement and the school s catalog constitute the entire agreement between the student and the school. 11. Every assignee of this agreement takes it subject to all claims and defenses of the student or his successors in interest arising under this agreement. 12. I understand that should I withdraw from the program prior to the completion of said program, I am responsible for returning all properties including undamaged textbooks, when applicable. BUYER S RIGHT TO CANCEL The student has the right to cancel the initial enrollment agreement until midnight of the fifth business day after the student has been admitted. If the right to cancel is not given to any perspective student at the time the agreement is signed, then the student has the right to cancel the agreement at any time and receive a refund on all monies paid to date with ten days of cancellation. Cancellation must be submitted to the authorized official of the school in writing. 6

Signatures: Administrator (Print) (Sign) Date: Student: (Print) (Sign) Date: If student is under 18 years of age Parent/Guardian :(Print) (Sign) 7

Receipt of Cancellation Form FOR CANCELLATIONS: I, request a cancellation of the Basic Nursing Assistant Training Program course provided by CJW. I understand that the procedure to receive a full refund of any unearned tuition, undamaged books, lab fees, minus the processing fee I must cancel before the first day of class. I must submit this written request to cancel the course directly to an administrator of CJW. I understand the administrator will give me a copy of this notice as my receipt to cancel the course providing me with a signature and date of the cancellation request. I also understand that if on personal initiative and without solicitation I enroll, start and complete course of instruction before midnight of the fifth business day after enrollment agreement is signed I am not subject to the cancellation provisions. I also understand that I am to return all books unmarked or undamaged before a refund will be granted. I can expect my refund within 3-5 business days. SIGNATURES: Administrator (Print) (Sign) Date: Student: (Print) (Sign) Date: If student is under 18 years of age Parent/Guardian :(Print) (Sign) Date: 8

MAKE-UP POLICY CJ WOODS expects 100% class and clinical attendance. If an emergency arises the student is expected to call and leave a message at the office. Any recognized absence will be allowed to be made up. Makeup clinical will be held on Sundays at the same time as regularly scheduled clinical. Depending on facility and instructor availability this make-up may be done during the next session, which may interfere with student being eligible to sit for the originally scheduled written competency exam date. The date and time will be determined by the administrator. If a student misses one unexcused clinical the student will be dropped from the class. EXCEPTIONS If in the event of bad weather conditions, emergencies out of the control of the administrators or training facilities, a make-up clinical will be scheduled. The student will be given the make-up date as earliest as possible in order to adjust their schedules accordingly. Make-ups will be held on Sundays during regularly scheduled clinical. 9

Complaints In accordance with Section 451.590 of the Illinois Administrative Code, any student or faculty who has a complaint will be given an opportunity to complete a CJW complaint form and has the right to have their complaint resolved promptly and fairly. Any student or faculty who files a written grievance shall not be subject to punitive action. Complaints against the school may be registered with the state board of education at the following Springfield or Chicago offices: Illinois State Board of Education Accountability Division Private Business and Vocational Schools Illinois State Board of Education Accountability Division Private Business and Vocational Schools 100 North First Street E230 100 West Randolph Suite 14-300 Springfield, IL 62777 Chicago, IL 60601 217-782-2948 312-814-2220 CJW will adhere to all regulations according to: Private Business and Vocational Schools Rules of the Illinois Administrative Code 451. Section 451.270 Instructional Program and Services I Lawanda Woods, RN, MSN, President of CJ Woods Foundation of Hope certify that I have complied with the statutes of this Act. Lawanda Woods, RN, MSN 10

Student Acknowledgement Form I have read the catalog and I understand the rules, requirements, regulations and Student Code of Conduct. I agree to abide by them. I understand that until my fees are paid in full I will not receive my certificate of course completion, which makes me ineligible to take the State (CNA) exam. I also understand that I will not be entered into the national board of registry until my fees are paid to CJW in full. Any returned checks will result in an additional $30.00 fee. Signature: Date: Please remove this page, sign and return to your instructor. 11

July 1 June 30 Reporting Period For the most recent 12 month reporting period July 1 through June 30: (a) The number of students who were admitted in the course of instruction as of July1 of reporting period; N/A (b) Additions during the year due to: a. New starts N/A b. Re-enrollments; N/A and c. Transfers into the course of instruction from other courses of instruction at the school N/A; (c) Total number of students admitted during the reporting period (the number of students reported under items above. N/A (d) Of the total course of instruction enrollment, the number of students who: a. Transferred out of the course of instruction to another course of instruction N/A; b. Competed or graduated from a course of instruction N/A; c. Withdrew from the school N/A; d. Are still enrolled N/A; (e) The number of students listed in item (11) (d) who: a. Were placed in their field of study N/A; b. Were placed in a related field N/A; c. Placed out of the field N/A; d. Were not available for placement due to personal reasons N/A; e. Were not employed N/A; f. The number of students who took a State Licensing examination or professional certification examination during the reporting period, as well as the number who passed N/A; g. The number of graduates who obtained employment in the field who did not use the school s placement assistance during the reporting period N/A; h. The average starting salary for all school graduates employed during this reporting period N/A. 12