Medical Assistant ENROLLMENT FORM

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EMERGENCY CONTACTS FULL NAME & PHONE NUMBER

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I have carefully read and received an exact copy of this enrollment agreement.

I understand that the school may terminate my enrollment if I fail to comply with attendance, academic, and financial requirements or if I fail to comply with the standards of conduct. While enrolled in the school I understand that I must maintain academic achievement of 70% and my tuition must be paid in full before a certificate of completion or credentialing is awarded

I hereby acknowledge that the school has made available to me all required disclosure information listed under the consumer information section of this enrollment agreement.

I understand that the school does not guarantee transferability of credit and that in most cases, credits or course work are not likely to transfer to another institution.

I understand that the school does not guarantee job placement to graduates upon program completion.

I understand that complaints, which cannot be resolved by direct negotiation with the school in accordance to its written grievance policy, may be filed by mail or email at [email protected]

I hereby acknowledge that the school has provided me with the GNPEC Student Disclosure Form

Type an Option

I have read and understand the online coursework requirements and agree to fulfill these responsibilities as a condition of enrollment.

I have read and understand the clinical training and externship requirements and agree to comply with the academic, professional, and clinical eligibility standards established by Genesis Allied Health Institute

Privacy Policy Acknowledgment

https://genesisalliedhealthinstitute.com/privacy-policy

By submitting this enrollment application, I acknowledge that I have reviewed the Genesis Allied Health Institute Privacy Policy.

I understand that the personal information I provide will be collected, maintained, and used for legitimate school purposes, including processing my application, communicating enrollment requirements, maintaining student records, and administering educational services, as described in the Privacy Policy.

☐ I acknowledge that I have read and understand the Genesis Allied Health Institute Privacy Policy.