Enroll Now Step 1 of 2 50% CommentsThis field is for validation purposes and should be left unchanged.Heart of Caregiving Academy, LLC 200 Beacon Parkway West, #107C, Birmingham, AL 35209 Phone: (205) 202-3983 This Enrollment Agreement is between Heart of Caregiving Academy, LLC and:Student's Name:Telephone:Your Email Address Street Address City State / Province / Region AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country The school agrees to provide the following training:Course or Program Title:Select CourseCombined Home Care Aide & Medication Safety Training (26HCM01)Home Care Aide Training (26HCA01)Medication Safety Training (26MST01)Combined Home Care Aide & Medication Safety Training (26HCM02)Home Care Aide Training (26HCA02)Medication Safety Training (26MST02)Combined Home Care Aide & Medication Safety Training (26HCM03)Medication Safety Training (26MST03)Medication Safety Training (26MST04)Medication Safety Training (26MST05)Medication Safety Training (26MST06)Home Care Aide Training (26HCA03)Home Care Aide Training (26HCA04)Medication Safety Training (26MST07)Combined Home Care Aide & Medication Safety Training (26HCM04)Home Care Aide Training (26HCA05)Medication Safety Training (26MST08)DateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formMedication Safety TrainingDateScheduleHoursThis field is hidden when viewing the formCombined Home Care Aide & Medication Safety TrainingDateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formHome Care Aide Training 25HCA02DateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formMedication Safety Training 25MST02DateScheduleHoursThis field is hidden when viewing the formCombined Home Care Aide & Medication Safety Training 26HCM01DateScheduleHoursDateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formHome Care Aide Training 26HCA01DateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formMedication Safety Training 26MST01DateScheduleHoursThis field is hidden when viewing the formCombined Home Care Aide & Medication Safety Training 26HCM02DateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formHome Care Aide Training 26HCA02DateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formMedication Safety Training (26MST02)DateScheduleHoursThis field is hidden when viewing the formCombined Home Care Aide & Medication Safety Training (26HCM03)DateScheduleHoursDateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formMedication Safety Training (26MST03)DateScheduleHoursThis field is hidden when viewing the formMedication Safety Training (26MST04)DateScheduleHoursThis field is hidden when viewing the formMedication Safety Training (26MST05)DateScheduleHoursThis field is hidden when viewing the formMedication Safety Training (26MST06)DateScheduleHoursThis field is hidden when viewing the formHome Care Aide Training (26HCA03)DateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formHome Care Aide Training (26HCA04)DateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formMedication Safety Training (26MST07)DateScheduleHoursThis field is hidden when viewing the formCombined Home Care Aide & Medication Safety Training (26HCM04)DateScheduleHoursDateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formHome Care Aide Training (26HCA05)DateScheduleHoursDateScheduleHoursDateScheduleHoursThis field is hidden when viewing the formMedication Safety Training (26MST08)DateScheduleHoursProduct Name Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Tuition: Price: Including Registration Fees: (Non-Refundable ) Price: Total cost for the course: This field is hidden when viewing the formProgram consists ofThis field is hidden when viewing the formweeks xThis field is hidden when viewing the formhours per week =Total hours.This field is hidden when viewing the formProgram consists ofThis field is hidden when viewing the formTuition:This field is hidden when viewing the formIncluding Registration Fees:This field is hidden when viewing the formTOTAL COST FOR THE COURSE: After paying the full tuition, A welcome packet will be emailed to their email address. if you choose to use the 50% payment option, the welcome packet will be emailed upon paying the balance. *Registration Fee: $100.00 (non-refundable registration fee) This field is hidden when viewing the formPayment Option Full Payment 50% + $100 Non-Refundable Deposit This field is hidden when viewing the formTuition FeeHome Care Aide Training Program $500Home Care Aide Program & Medication Safety Training $550Caregiver Medication Safety Training (If taken separately) $100This field is hidden when viewing the formTuition FeeHome Care Aide Training Program $250Home Care Aide Program & Medication Safety Training $275Caregiver Medication Safety Training (If taken separately) $50This field is hidden when viewing the formRegistration Fee date: MM slash DD slash YYYY Tuition Payment Option Please Note: If students choose to pay 50% of the tuition plus the $100 non-refundable registration fee, the remaining balance is due no later than five (5) days before the start date of the class in which the student is enrolled. Students are strongly encouraged to pay the total tuition amount at the time of enrollment, as this secures placement in the class and ensures a smooth registration process.Agreement is Binding: This agreement will be binding only when it has been fully completed, signed, and dated by the student and an authorized representative of the school prior to the time instruction begins. Changes in the Agreement: Any changes to this agreement must be acknowledged in writing by both the student and an authorized representative of the school. Effective Date of Acceptance: I certify that I have read and understand the cancellation and refund policy and the complaint procedure. I have received a copy of the school catalog, and I am entitled to an exact copy of this Enrollment Agreement and any other documents I sign. Cancellation of Classes: The school reserves the right to cancel a starting class if enrollment is insufficient. Such a cancellation will entitle the student to a full refund of all money paid.Registration and Refund Policy: Registration Fee A non-refundable $100 registration fee is required to secure a student’s seat in any course. This fee is due at the time of enrollment and is not eligible for refund under any circumstances. Tuition & Fee Schedule Item Amount Refundable? Registration Fee $100 Non-refundable Home Care Aide Training Program $500 Yes (per refund policy) Home Care Aide Program & Medication Safety Training $550 Yes (per refund policy) Caregiver Medication Safety Training (If taken separately) $100 Yes (per refund policy) Tuition Payment The full balance of tuition must be paid prior to the first day of class. Cancellation and Refund Terms Students may cancel their enrollment within 72 hours of enrolling in a course. Refunds for the refundable portion of tuition (excluding the registration fee) will be issued as follows: Cancellation within 72 hours of enrollment: 100% of the refundable tuition will be returned (excluding the non-refundable registration fee). Cancellation after the first class session but before the second: 50% of the refundable tuition will be returned (excluding the non-refundable registration fee). Cancellation after the second class session but before the third: 25% of the refundable tuition will be returned (excluding the non-refundable registration fee). Cancellation after the third class session has begun: No refunds will be issued. Refund Request Process All refund requests must be submitted in writing to the Director of the Academy and must include the student’s name, course enrolled, and date of enrollment. Approved refunds will be processed within 30 business days from the date the written request is received and in the form of a check. NOTICE TO PROSPECTIVE STUDENT: DO NOT SIGN THIS AGREEMENT BEFORE READING IT IN FULL Student’s Name (Print):Student’s Signature:Date: MM slash DD slash YYYY Parent or Guardian Name (if applicable):Parent/Guardian Signature:Date: MM slash DD slash YYYY Authorized School Representative/Director: Dr. Marcia Bygrave Signature:Date: MM slash DD slash YYYY Upload Driver’s License or Picture ID. If you are having any difficulties downloading your Driver’s license or Picture ID, don't hesitate to get in touch with us.Max. file size: 6 GB. Refund Policy At Heart of Caregiving Academy, LLC, we understand that life circumstances can change. The following policy outlines the terms and conditions under which students may cancel their enrollment and request a tuition refund. Cancellation and Refund Terms Students may cancel their enrollment within 72 hours of enrolling in a course. Refunds for the refundable portion of tuition (excluding the registration fee) will be issued as follows: Cancellation within 72 hours of enrollment:100% of the refundable tuition will be returned (excluding the non-refundable registration fee). Cancellation after the first class session but before the second:50% of the refundable tuition will be returned (excluding the non-refundable registration fee). Cancellation after the second class session but before the third:25% of the refundable tuition will be returned (excluding the non-refundable registration fee). Cancellation after the third class session has begun:No refunds will be issued. Refund Request Process All refund requests must be submitted in writing to the Director of the Academy and must include the student’s name, course enrolled, and date of enrollment. Approved refunds will be processed within 30 business days from the date the written request is received and in the form of a check. Attendance Policy Attendance is required to receive a certificate of completion for each program in which a student is enrolled. Students must be present for all scheduled hours of the Home Care Aide Training Program and/or the Caregiver Medication Safety Program to earn their certificate. Attendance is mandatory for every scheduled class session, without exception. One excused absence may be permitted with prior approval from the instructor and must be made up within 7 days. Unexcused absences or failure to complete required hours may result in dismissal from the program. Tardiness of more than 15 minutes may be counted as an absence. Students must sign in and out daily for attendance tracking. (Required) I have read and agree to the terms of this policy Total Secure Credit Card Card Holder* Card Number* Card Expiration* Card CVV*