Enrollment Agreement (U1) Unit 1 Application Class Information: Enter Class Date(s): ---Jun 4th - 13th (DAY)Jul 9th -18th (DAY)Jul 16th - Aug 9th (NIGHT)Aug 6th - 15th (DAY) Confirm Class Date(s): ---Jun 4th - 13th (DAY)Jul 9th -18th (DAY)Jul 16th - Aug 9th (NIGHT)Aug 6th - 15th (DAY) * indicates REQUIRED fields below Student Information: Have you attended classes here before? YesNo Company Name: First Name:* Middle Name: Last Name:* Nickname: for class purposes Social Security Number:* Street Address: City: State: ---ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Zip Code: Home Phone: Business Phone: Fax Number: Cell Phone: Email Address:* How did you hear about us? ---Internet/WebSocial MediaFormer StudentREALTOR®Wyatt SignWord of MouthNewspaperYellow PagesVoice MailOther Payment Information: Payment Choices explained: TUITION options: Either FULL Amount (or) DEPOSIT will hold your seat in class; balance due first day of class. Credit Card is required for all ONLINE submissions. Checks, Cash, and Money Orders accepted at main office or by mail. TEXTBOOK options: Book is included in price & will be given first day of class. To get a head start, you can request the book before class: We will mail book to the address provided on this form. (Include $7 for shipping fee.) -- OR -- Come by the office to pick book up (no charge) PAYMENT CHOICE : **read* 'Payment Choices explained' above, then select oneDEPOSIT OPTIONS: (balance due at first of class)- - - - - - - - - -$250 - Class Deposit only (don't mail book prior to class)$290 - Class Deposit + Book (I will pick up book from office)$297 - Class Deposit + Mail Book (to address provided)- - - - - - - - - -FULL AMOUNT OPTIONS:$525 - Full Payment (don't mail book prior to class)$532 - Full Payment (mail book to address provided) CHARGE to Credit Card: *choose one:VISAMasterCard «« VISA or MasterCard ONLY Card #: * 3-digit security code: * Expiration Date (MM/YY): * Name on Card: * Billing Address Number (used to process credit card): * Billing Zip Code: * Additional Notes to Office Manager (optional): Acceptance of Terms and Policies:* (check both boxes below to accept, after reading the Terms and Policies) Yes, I understand the Terms and Policies as part of this agreement. I am keeping a copy for my records. Yes, I understand #2 of the Terms and Policies require me to give timely notice or forfeit $250 if I do not show.