Common use of STUDENT ACKNOWLEDGMENTS Clause in Contracts

STUDENT ACKNOWLEDGMENTS. Student Initial I understand that I must show up to class lucid, and mentally and physically rested and prepared. I understand that if the instructor feels I am not prepared I can be questioned, and if necessary dismissed from that session with the instruction to be prepared for the next session. Students, who are under the influence of alcohol, elicit drugs, prescription drugs or any other mind or body-altering substances cannot participate in class. Student Initial I understand that disruptive behavior, vulgar language or inappropriate attire will not be tolerated during class. If after a warning from an instructor or other PTS staff member the offense continues I may be asked to leave class with out the possible option to return. In this case no refunds will be given. *Scrubs are the preferred attire but are not required. Student Initial I understand the risks associated with drawing blood, contracting diseases and am aware that phlebotomy procedures in class will be performed on fellow students, volunteers and staff at Phlebotomy Training Specialists. I also understand that any injury sustained to me or the person I am performing phlebotomy on is solely my responsibility and will hold Phlebotomy Training Specialists harmless. Student Initial I understand that Phlebotomy Training Specialists does not offer job placement. However, resume assistance is available as well as an in class discussion on how to obtain and where to look for employment. Student Initial I understand that attendance is mandatory to successfully pass this course. Make up class time will be available by contacting student services only. I understand that I will not be able to schedule or attend make up classes once my registered class has concluded until my tuition is paid in full as explained under General Information on page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I must log into my student account at xxxxxxxx.xxxxxxxxxxxxx.xxx and check the spelling/format of my name and that how my name appears here is EXACTLY how it will appear on my certificate. I also understand that there is a $15 Fee for Certificate Reprints as explained under Payment/Certificate/Exam Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that if I cannot complete the course I originally registered for, before I can be reassigned to another class I must have all tuition paid in full. I also understand that if I need to be reassigned to a class for any reason I must contact student services to do so. Student Initial I understand the PTS Refund Policy and am aware that all requests to withdraw from the program must be done in writing as explained under General Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I will not be able to graduate or obtain my certification until I have completed the course and paid ALL tuition in full as explained under Payment/Certificate Information on page 2 of this Registration/ Enrollment Agreement. Student Initial I understand that in order to sit for the National Exam, I must have ALL tuition paid in full. I also understand that if I have not paid my National Exam fee at least ONE WEEK prior to the test date I may not be guaranteed a seat or exam on test day as explained under Payment/Certificate/Exam Information on Page 2 of this Registration/Enrollment Agreement. I have read and understand this Registration/Enrollment Agreement and agree with the terms set forth therein. By signing below, the student agrees to pay Phlebotomy Training Specialists (“school”) the total stated tuition & fees. The school agrees to provide the occupational training in accordance with the provisions of the school’s current Catalog Volume No. 5 January 2018 (“Catalog”). Payment of all monies due shall be a condition of continuing enrollment. Upon satisfactory completion of all academic and skill requirements and when all financial obligations to the school have been met the school will award the Phlebotomy Technician Certificate to the student. The student and school understand that this Enrollment Agreement, WHICH INCLUDES THE REFUND POLICY may not be amended except in writing and signed by both parties. A copy of a current school catalog and fully executed copy of this enrollment agreement will be sent via email. Student Signature Date Authorized Representative Date In consideration of the opportunity to receive phlebotomy instruction, training, and other services from Phlebotomy Training Specialists (“PTS”), I agree to the following. Although PTS has taken reasonable steps to make the services provided by PTS safe in an effort to avoid injury, I acknowledge and agree that there are inherent risks of physical injury and other damages associated with phlebotomy instruction and training that remain to exist. These inherent risks include, but are not limited to, injury caused by in-class attempts to draw blood from each other by the participants, like myself, receiving instruction and training from PTS. I understand that the above description of risks associated with the phlebotomy instruction and training is not complete, and that other unknown or unanticipated risks may, however very unlikely, result in injury or death. My participation in phlebotomy instruction and training is purely voluntary, based upon my own assessment of all relevant facts and circumstances, in spite of the associated risks. I acknowledge that I am not relying on any oral, written or visual representations made by PTS, including those made in its brochures or other promotional material, in deciding to voluntarily accept the risks associated with my participation in this phlebotomy instruction and training. I hereby agree to accept the risk of any such injury or damage; in addition I agree not to hold PTS, or any of its owners, employees or agents, responsible in any way for any injuries or damages I may incur during, or related in any manner to, the phlebotomy instruction and training I will receive from PTS, even if PTS or its employees or agents act negligently. I also understand that PTS is neither responsible nor liable for my travel to and from classes. I come and go of my own free will and choice and agree not to hold PTS accountable in any way should I become injured in any manner during those travels. In the event I incur any injury arising from, or related in any manner to, my participation in any phlebotomy instruction or training I receive from PTS, I will immediately notify a PTS instructor of the nature and cause of such injury. I hereby agree to defend, indemnify and hold PTS and its owners, employees and agents harmless from any liability, damages or other costs, including, but not limited to, attorney fees and other costs of litigation, related to, or arising from, my participation in any phlebotomy instruction or training I receive from PTS and/or any of my activities related thereto. The prevailing party in any legal action to interpret and/or enforce any of the terms of this Release of Liability shall also be awarded their reasonable attorney fees and other costs and expenses incurred regarding that legal action. This Release of Liability shall be governed by the laws of the State of Utah. Any dispute between me and PTS shall, upon the written demand of either party, be submitted to arbitration before a single arbitrator whose decision shall be binding and conclusive on all parties. Such arbitration shall generally comply with the arbitration rules of the American Arbitration Association (“AAA”), but need not be conducted or otherwise administered by the AAA, and such arbitration shall be conducted by a provider of arbitration services other than the AAA upon the demand of either party. Such arbitration shall be conducted in the State of Utah regardless of where I received phlebotomy instruction or training and regardless of where I may be located at the time of such dispute. I hereby acknowledge that I have carefully read the above Release of Liability and fully understand its contents. I am aware that I am releasing certain legal rights that I may otherwise have by signing this Release of Liability. In return, I will be allowed to participate in the phlebotomy instruction and training sponsored or conducted by PTS. I have had the opportunity to consult with my own attorney, if I so desired, regarding the meaning and effect of this Release of Liability before I signed it. I now sign this Release of Liability of my own free will and choice. Student Signature Date Printed Name Student Tracking Form Location of Training: Class Start Date: _ State law requires us to track you after graduation. During class at PTS you will be participating in the “Employment Presentation” which covers where to work, how to apply, what to wear, and other resources that correlate to gaining employment. No sooner than 60 days after graduation our staff will begin attempting to contact you by mail, email and phone call/text to ask you questions regarding employment. Sharing this information is arbitrary and you are not required to respond to any of our requests for information. In addition to our employment presentation given during class, we offer resume review. Just send the most recent copy of your resume to xxxx@xxxxxxxxxxxxx.xxx and one of our staff members will review and provide feedback within 72 hours. This form will be used to record the data should you choose to participate in reporting it to us. The collecting of the initial information IS required. Student Name _ Phone # Male Female _ Address City State Zip County SSN (Last 4 digits): Email DOB (MM/DD/YYYY) Are you on disability? Yes No Are you a Veteran? Yes NO Ethnicity: Hispanic/Latino Hawaiian/Pacific Islander Asian Caucasian Native/AlaskanAmerican African American Check all that apply below: I am using the certification to strengthen my resume for my existing medical career. I am currently employed in a health care related field and I am not seeking employment. I am currently employed in a non health care related field and I am not seeking employment. Students should be contacted by phone, mail and email or text message 60-180 days after the student graduates to ascertain whether or not they have gained employment in the field.

STUDENT ACKNOWLEDGMENTS. Student Initial I have read and understand all provisions of this agreement, and I have been given a copy of it for my records. (Parents must also sign if you are under 18 years of age.) I understand that my enrollment and The Art Institute’s obligations under this Enrollment Agreement (except the cancellation and refund provisions) may be terminated by The Art Institute if I must show up fail to class lucidcomply with The Art Institute’s attendance, conduct, academic, and/or financial requirements. I understand that The Art Institute also reserves the right to deny my enrollment if it is determined (i) that I have demonstrated poor academic potential as determined through evaluation of transcript records or any other academic evaluations deemed appropriate for the program selected, and/or (ii) that I do not meet all financial obligations related to enrollment and mentally continuing enrollment. I understand that my financial obligations to The Art Institute mustbepaidinfullbeforeadiplomaordegree may be awarded and physically rested before transcripts will be issued. Both sides of the Enrollment Agreement and preparedthe financial plan, together with the catalog and other published Art Institute policies, procedures, provisions of any attached rider(s) signed by me, student conduct codes, andseparatestudenthousingagreement, if any, shallconstitute theentire Agreement between the student and The Art Institute. I understand and agree that they supersede any prior or contemporaneous oral or written agreements or statements and may not be modified without the written agreement of The Art Institute President. I understand that if I obtain a loan to pay for an educational program, I will have the instructor feels responsibility to repay the full amount of the loan plus interest, less the amount of any refund. I further understand that if I am eligible for a loan guaranteed by the federal or state government and I default on the loan, one or both of the following may occur: 1.) The federal or state government or a loan guarantee agency may take action against me, which includes applying any income tax refund to which the person is entitled to reduce the balance owed on the loan, 2.) I may not prepared I can be questioned, and if necessary dismissed from that session with the instruction to be prepared eligible for the next session. Students, who are under the influence of alcohol, elicit drugs, prescription drugs or any other mind or body-altering substances cannot participate in class. Student Initial I understand that disruptive behavior, vulgar language or inappropriate attire will not be tolerated during class. If after a warning from an instructor federal student financial aid at another institution or other PTS staff member government assistance until the offense continues I may be asked loan is repaid. Iacceptthat, to leave class with out the possible option theextentpermittedbylaw, Iamresponsibleforallreasonable collection agency and attorney fees incurred in attempting to return. In this case no refunds will be given. *Scrubs are the preferred attire but are not required. Student Initial I understand the risks associated with drawing blood, contracting diseases and am aware that phlebotomy procedures in class will be performed on fellow students, volunteers and staff at Phlebotomy Training Specialistscollect my unpaid debt to The Art Institute. I also understand that any injury sustained to me or the person I am performing phlebotomy on is solely my responsibility this agreement constitutes a binding contract upon signature by student and will hold Phlebotomy Training Specialists harmlessacceptance by The Art Institute. Student Initial I understand that Phlebotomy Training Specialists does not offer job placement. However, resume assistance is available as well as an in class discussion on how to obtain and where to look for employment. Student Initial I understand that attendance is mandatory to successfully pass this course. Make up class time will be available by contacting student services only. I understand that I will not be able to schedule or attend make up classes once my registered class has concluded until my tuition is paid in full as explained under General Information on page 2 Any holder of this Registration/Enrollment Agreement. Student Initial I understand that I must log into my student account at xxxxxxxx.xxxxxxxxxxxxx.xxx consumer credit contract is subject to all claims and check defenses which the spelling/format of my name and that how my name appears here is EXACTLY how it will appear on my certificate. I also understand that there is a $15 Fee for Certificate Reprints as explained under Payment/Certificate/Exam Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that if I cannot complete the course I originally registered for, before I can be reassigned to another class I must have all tuition paid in full. I also understand that if I need to be reassigned to a class for any reason I must contact student services to do so. Student Initial I understand the PTS Refund Policy and am aware that all requests to withdraw from the program must be done in writing as explained under General Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I will not be able to graduate debtorcouldassertagainstthesellerofgoodsorservicesobtainedpursuant hereto or obtain my certification until I have completed the course and paid ALL tuition in full as explained under Payment/Certificate Information on page 2 of this Registration/ Enrollment Agreement. Student Initial I understand that in order to sit for the National Exam, I must have ALL tuition paid in full. I also understand that if I have not paid my National Exam fee at least ONE WEEK prior to the test date I may not be guaranteed a seat or exam on test day as explained under Payment/Certificate/Exam Information on Page 2 of this Registration/Enrollment Agreement. I have read and understand this Registration/Enrollment Agreement and agree with the terms set forth thereinproceeds hereof. By signing below, the student agrees to pay Phlebotomy Training Specialists (“school”) the total stated tuition & fees. The school agrees to provide the occupational training in accordance with the provisions of the school’s current Catalog Volume No. 5 January 2018 (“Catalog”). Payment of all monies due shall be a condition of continuing enrollment. Upon satisfactory completion of all academic and skill requirements and when all financial obligations to the school have been met the school will award the Phlebotomy Technician Certificate to the student. The student and school understand that this Enrollment Agreement, WHICH INCLUDES THE REFUND POLICY may not be amended except in writing and signed by both parties. A copy of a current school catalog and fully executed copy of this enrollment agreement will be sent via email. Student Signature Date Authorized Representative Date In consideration of the opportunity to receive phlebotomy instruction, training, and other services from Phlebotomy Training Specialists (“PTS”), I agree to the following. Although PTS has taken reasonable steps to make the services provided by PTS safe in an effort to avoid injury, I acknowledge and agree that there are inherent risks of physical injury and other damages associated with phlebotomy instruction and training that remain to exist. These inherent risks include, but are not limited to, injury caused by in-class attempts to draw blood from each other Recovery here under by the participants, like myself, receiving instruction and training from PTS. I understand that debtor shall not exceed amounts paid by the above description of risks associated with the phlebotomy instruction and training is not complete, and that other unknown or unanticipated risks may, however very unlikely, result in injury or deathdebtor. My participation in phlebotomy instruction and training is purely voluntary, based upon my own assessment of all relevant facts and circumstances, in spite of the associated risks. I acknowledge that I am not relying on any oral, written or visual representations made by PTS, including those made in its brochures or other promotional material, in deciding to voluntarily accept the risks associated with my participation in this phlebotomy instruction and training. I hereby agree to accept the risk of any such injury or damage; in addition I agree not to hold PTS, or any of its owners, employees or agents, responsible in any way for any injuries or damages I may incur during, or related in any manner to, the phlebotomy instruction and training I will receive from PTS, even if PTS or its employees or agents act negligently. I also understand that PTS is neither responsible nor liable for my travel to and from classes. I come and go of my own free will and choice and agree not to hold PTS accountable in any way should I become injured in any manner during those travels. In the event I incur any injury arising from, or related in any manner to, my participation in any phlebotomy instruction or training I receive from PTS, I will immediately notify a PTS instructor of the nature and cause of such injury. I hereby agree to defend, indemnify and hold PTS and its owners, employees and agents harmless from any liability, damages or other costs, including, but not limited to, attorney fees and other costs of litigation, related to, or arising from, my participation in any phlebotomy instruction or training I receive from PTS and/or any of my activities related thereto. The prevailing party in any legal action to interpret and/or enforce any of the terms of this Release of Liability shall also be awarded their reasonable attorney fees and other costs and expenses incurred regarding that legal action. This Release of Liability shall be governed by the laws of the State of Utah. Any dispute between me and PTS shall, upon the written demand of either party, be submitted to arbitration before a single arbitrator whose decision shall be binding and conclusive on all parties. Such arbitration shall generally comply with the arbitration rules of the American Arbitration Association (“AAA”), but need not be conducted or otherwise administered by the AAA, and such arbitration shall be conducted by a provider of arbitration services other than the AAA upon the demand of either party. Such arbitration shall be conducted in the State of Utah regardless of where I received phlebotomy instruction or training and regardless of where I may be located at the time of such dispute. I hereby acknowledge signature signifies that I have carefully read readandunderstandallaspectsofthisagreementanddorecognizemylegal responsibilities in regard to this contract. Estimated Monthly Supplies (per month): Supplies: $100/month Texts: $75/month Thestudentisresponsiblefortuitionandfeespertainingtotheprogram’s requiredcourseofstudy. Thetuitionandfeescontainedinthis Enrollment Agreement are subject to change. The per credit hour rate is subject to an increase at least once per calendar year which may increase the above Release of Liability total amount for the program. The adjustment to the per credit hour rate may occur before the student begins classes and fully understand its contents. I am aware that I am releasing certain legal rights that I may otherwise have by signing this Release of Liability. In return, I the student’s program will be allowed calculated using the new rate. Any changes to participate in the phlebotomy instruction tuition and training sponsored or conducted by PTS. I have had the opportunity to consult with my own attorney, if I so desired, regarding the meaning and effect of this Release of Liability before I signed it. I now sign this Release of Liability of my own free will and choice. Student Signature Date Printed Name Student Tracking Form Location of Training: Class Start Date: _ State law requires us to track you after graduation. During class at PTS you fees will be participating in the “Employment Presentation” which covers where published to workstudents. The starting kit consists of basic equipment, how to apply, what to wearfirst-quarter textbooks, and other resources that correlate to gaining employmentmaterial needed for beginning each program. No sooner than 60 days after graduation our staff will begin attempting to contact you by mail, email and phone call/text to ask you questions regarding employment. Sharing this information is arbitrary and you are not required to respond to any of our requests for information. In addition to our employment presentation given during class, we offer resume review. Just send the most recent copy of your resume to xxxx@xxxxxxxxxxxxx.xxx and one of our staff members will review and provide feedback within 72 hours. This form will be used to record the data should you choose to participate in reporting it to us. The collecting A list of the initial information IS requiredcomponents of the starting kit is provided to each enrolled student. Student Name _ Phone # Male Female _ Address City State Zip County SSN (Last 4 digits): Email DOB (MM/DD/YYYY) Are you on disability? Yes No Are you a Veteran? Yes NO Ethnicity: Hispanic/Latino Hawaiian/Pacific Islander Asian Caucasian Native/AlaskanAmerican African American Check all that apply below: I am using the certification to strengthen my resume for my existing medical careerThese materials may be purchased at The Art Institute or most supply stores. I am currently employed in a health care related field and I am not seeking employment. I am currently employed in a non health care related field and I am not seeking employment. Students should be contacted by phone, mail and email or text message 60-180 days after the student graduates to ascertain whether or not they have gained employment in the fieldKit is optional.

STUDENT ACKNOWLEDGMENTS. Student Initial I understand that I must show up to class lucid, and mentally and physically rested and prepared. I understand that if the instructor feels I am not prepared I can be questioned, and if necessary necessary, dismissed from that session with the instruction to be prepared for the next session. Students, who are under the influence of alcohol, elicit illicit drugs, prescription drugs or any other mind or body-altering substances cannot participate in class. Student Initial I understand that disruptive behavior, vulgar language language, or inappropriate attire will not be tolerated during class. If the offense continues after a warning from an instructor or other PTS staff member the offense continues member, I may will be asked to leave class with out without the possible option to return. In PTS will abide by the Refund Policy set forth in this case no refunds will be givenagreement. *Scrubs are the preferred attire but are not required. Student Initial I understand the risks associated with drawing blood, contracting diseases and am aware that phlebotomy procedures in class will be performed on fellow students, volunteers and staff at Phlebotomy Training Specialists. I also understand that any injury sustained to me or the person I am performing phlebotomy on is solely my responsibility and will hold Phlebotomy Training Specialists harmless. Student Initial I understand that Phlebotomy Training Specialists does not offer job placement. However, resume assistance is available available, as well as an in in-class discussion on how to obtain and where to look for employment. Student Initial _ I understand that while PTS will make every effort to hold classes as scheduled, there may be a disruption in projected scheduling due to unforeseen circumstances. I acknowledge that PTS will not make any financial compensations for rescheduling, however, they will also not charge any additional fees for rescheduling. PTS will offer multiple options to complete my course in a timely manner. Should I choose to withdraw from training, the published refund policy will apply. Student Initial I understand that attendance is mandatory to successfully pass this course. Make up class time will be available by contacting student services Student Services only. I understand that I will not be able to schedule or attend make up classes once my registered class has concluded until my tuition is paid in full as explained under General Information on page 2 of in this Registration/Enrollment Agreement. Student Initial I acknowledge that I am responsible for the cost of the full tuition and fees associated with the program. I understand that failure to make consistent payments (after my removal from class) to the school will result in my account being sent to collections. I also understand that if I withdraw from the program prior to completion, I am financially responsible for the prorated tuition and fees for the classes which I did attend. Student Initial I understand that I must log into my student account at xxxxxxxx.xxxxxxxxxxxxx.xxx and check the spelling/format of my name and that how my name appears here there is EXACTLY how it will appear on my certificate. I also understand that there is a $15 20 Printing Fee for Certificate Reprints as should I request a physical copy. This is explained under Payment/Certificate/Exam State Certification Information on Page 2 of in this Registration/Enrollment Agreement. Student Initial I understand that I cannot miss the first or second scheduled day of class. I understand that if I miss either of these classes, I will be removed from the class and I will be required to select another available class schedule. Student Initial I understand that if I cannot complete the course I originally registered for, before I can be reassigned to another class class, I must have all tuition paid in full. I also understand that if I need to be reassigned to a class for any reason I must contact student services Student Services to do so. Student Initial I understand the PTS Refund Policy and am aware that all requests to withdraw from the program must be done in writing as explained under General Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I will not be able to graduate or obtain my certification until I have completed the course and paid ALL tuition in full as explained under Payment/Certificate Information on page 2 Payment Policy section of this Registration/ Enrollment Agreement. Student Initial I understand that in order to sit for the National Exam, I must have ALL tuition paid in full. I also understand that if I have not paid my National Exam fee at least ONE WEEK prior to the test date I may will not be guaranteed a seat or exam on test day as explained under Payment/Certificate/the Exam Information on Page 2 section of this Registration/Enrollment Agreement. I have read and understand this Registration/Enrollment Agreement and agree with the terms set forth therein. By signing belowthe Enrollment Agreement, I understand my right to receive an exact signed copy of the student agrees agreement and by signing the agreement the institution understands its obligation to pay immediately provide me with an exact signed copy of the agreement. Phlebotomy Training Specialists (“school”) the total stated guarantees that it will not raise tuition & fees. The school agrees to provide the occupational training in accordance with the provisions of the schoolduring student’s current Catalog Volume No. 5 January 2018 (“Catalog”). Payment of all monies due shall be a condition of continuing enrollment. Upon satisfactory completion of all academic When signed and skill requirements and when all financial obligations to the school have been met the school will award the Phlebotomy Technician Certificate to the student. The student and school understand that this Enrollment Agreement, WHICH INCLUDES THE REFUND POLICY may not be amended except in writing and signed dated by both partiesparties this agreement is a legally binding instrument. A copy Phlebotomy Training Specialists is authorized by the Tennessee Higher Education Commission. This authorization must be renewed each year and is based on an evaluation of a current school catalog minimum standards concerning quality of education, ethical business practices, and fully executed copy of this enrollment agreement will be sent via emailfiscal responsibility. AM PM Student Signature Date Authorized Representative Date In consideration of the opportunity to receive phlebotomy instruction, training, and other services from Phlebotomy Training Specialists (“PTS”), I agree to the following. Although PTS has taken reasonable steps to make the services provided by PTS safe in an effort to avoid injury, I acknowledge and agree that there are inherent risks of physical injury and other damages associated with phlebotomy instruction and training that remain to exist. These inherent risks include, but are not limited to, injury caused by in-class attempts to draw blood from each other by the participants, like myself, receiving instruction and training from PTS. I understand that the above description of risks associated with the phlebotomy instruction and training is not complete, and that other unknown or unanticipated risks may, however very unlikely, result in injury or death. My participation in phlebotomy instruction and training is purely voluntary, based upon my own assessment of all relevant facts and circumstances, in spite of the associated risks. I acknowledge that I am not relying on any oral, written or visual representations made by PTS, including those made in its brochures or other promotional material, in deciding to voluntarily accept the risks associated with my participation in this phlebotomy instruction and training. I hereby agree to accept the risk of any such injury or damage; in addition I agree not to hold PTS, or any of its owners, employees or agents, responsible in any way for any injuries or damages I may incur during, or related in any manner to, the phlebotomy instruction and training I will receive from PTS, even if PTS or its employees or agents act negligently. I also understand that PTS is neither responsible nor liable for my travel to and from classes. I come and go of my own free will and choice and agree not to hold PTS accountable in any way should I become injured in any manner during those travels. In the event I incur any injury arising from, or related in any manner to, my participation in any phlebotomy instruction or training I receive from PTS, I will immediately notify a PTS instructor of the nature and cause of such injury. I hereby agree to defend, indemnify and hold PTS and its owners, employees and agents harmless from any liability, damages or other costs, including, but not limited to, attorney fees and other costs of litigation, related to, or arising from, my participation in any phlebotomy instruction or training I receive from PTS and/or any of my activities related thereto. The prevailing party in any legal action to interpret and/or enforce any of the terms of this Release of Liability shall also be awarded their reasonable attorney fees and other costs and expenses incurred regarding that legal action. This Release of Liability shall be governed by the laws of the State of Utah. Any dispute between me and PTS shall, upon the written demand of either party, be submitted to arbitration before a single arbitrator whose decision shall be binding and conclusive on all parties. Such arbitration shall generally comply with the arbitration rules of the American Arbitration Association (“AAA”), but need not be conducted or otherwise administered by the AAA, and such arbitration shall be conducted by a provider of arbitration services other than the AAA upon the demand of either party. Such arbitration shall be conducted in the State of Utah regardless of where I received phlebotomy instruction or training and regardless of where I may be located at the time of such dispute. I hereby acknowledge that I have carefully read the above Release of Liability and fully understand its contents. I am aware that I am releasing certain legal rights that I may otherwise have by signing this Release of Liability. In return, I will be allowed to participate in the phlebotomy instruction and training sponsored or conducted by PTS. I have had the opportunity to consult with my own attorney, if I so desired, regarding the meaning and effect of this Release of Liability before I signed it. I now sign this Release of Liability of my own free will and choice. Student Signature Date Printed Name Student Tracking Form Location of Training: Class Start Date: _ State law requires us to track you after graduation. During class at PTS you will be participating in the “Employment Presentation” which covers where to work, how to apply, what to wear, and other resources that correlate to gaining employment. No sooner than 60 days after graduation our staff will begin attempting to contact you by mail, email and phone call/text to ask you questions regarding employment. Sharing this information is arbitrary and you are not required to respond to any of our requests for information. In addition to our employment presentation given during class, we offer resume review. Just send the most recent copy of your resume to xxxx@xxxxxxxxxxxxx.xxx and one of our staff members will review and provide feedback within 72 hours. This form will be used to record the data should you choose to participate in reporting it to us. The collecting of the initial information IS required. Student Name _ Phone # Male Female _ Address City State Zip County SSN (Last 4 digits): Email DOB (MM/DD/YYYY) Are you on disability? Yes No Are you a Veteran? Yes NO Ethnicity: Hispanic/Latino Hawaiian/Pacific Islander Asian Caucasian Native/AlaskanAmerican African American Check all that apply below: I am using the certification to strengthen my resume for my existing medical career. I am currently employed in a health care related field and I am not seeking employment. I am currently employed in a non health care related field and I am not seeking employment. Students should be contacted by phone, mail and email or text message 60-180 days after the student graduates to ascertain whether or not they have gained employment in the field.Time

STUDENT ACKNOWLEDGMENTS. Student Initial I understand that I must show up to class lucid, and mentally and physically rested and prepared. I understand that if the instructor feels I am not prepared I can be questioned, and if necessary dismissed from that session with the instruction to be prepared for the next session. Students, who are under the influence of alcohol, elicit illicit drugs, prescription drugs or any other mind or body-altering substances cannot participate in class. Student Initial I understand that disruptive behavior, vulgar language or inappropriate attire will not be tolerated during class. If after a warning from an instructor or other PTS staff member the offense continues I may be asked to leave class with out the possible option to return. In this case no refunds will be given. *Scrubs are the preferred attire but are not required. Student Initial I understand the risks associated with drawing blood, contracting diseases and am aware that phlebotomy procedures in class will be performed on fellow students, volunteers and staff at Phlebotomy Training Specialists. I also understand that any injury sustained to me or the person I am performing phlebotomy on is solely my responsibility and will hold Phlebotomy Training Specialists harmless. Student Initial I understand that Phlebotomy Training Specialists does not offer job placement. However, resume assistance is available as well as an in class discussion on how to obtain and where to look for employment. Student Initial _ I understand that while PTS will make every effort to hold classes as scheduled, there may be a disruption in projected scheduling due to unforeseen circumstances. I acknowledge that PTS will not make any financial compensations for rescheduling, however, they will also not charge any additional fees for rescheduling. PTS will offer multiple options to complete my course in a timely manner. Should I choose to withdraw from training, the published refund policy will apply. Student Initial I understand that attendance is mandatory to successfully pass this course. Make up class time will be available by contacting student services Student Services only. I understand that I will not be able to schedule or attend make up classes once my registered class has concluded until my tuition is paid in full as explained under General Information on page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I must log into my student account at xxxxxxxx.xxxxxxxxxxxxx.xxx and check the spelling/format of my name and that how my name appears here is EXACTLY how it will appear on my certificate. I also understand that there is a $15 20 Fee for Certificate Reprints Prints as explained under Payment/Certificate/Exam State Certification Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I cannot miss the first or second scheduled day of class. I understand that if I miss the first or second scheduled day of class, I will be removed from the class and I will be required to select another available class schedule. Student Initial I understand that if I cannot complete the course I originally registered for, before I can be reassigned to another class I must have all tuition paid in full. I also understand that if I need to be reassigned to a class for any reason I must contact student services Student Services to do so. Student Initial I understand the PTS Refund Policy and am aware that all requests to withdraw from the program must be done in writing as explained under General Information on Page 2 of in this Registration/Enrollment Agreement. Student Initial I acknowledge that I am responsible for the cost of the full tuition and fees associated with the program. I understand that failure to make consistent payments to the school will result in my account being sent to collections. I also understand that if I withdraw from the program prior to completion, I am financially responsible for the prorated tuition and fees for the classes which I did attend. Student Initial I understand that I will not be able to graduate or obtain my certification until I have completed the course and paid ALL tuition in full as explained under Payment/Certificate Information on page 2 of in this Registration/ Enrollment Agreement. Student Initial I understand that in order to sit for the National Exam, I must have ALL tuition paid in full. I also understand that if I have not paid my National Exam fee at least ONE WEEK prior to the test date I may not be guaranteed a seat or exam on test day as explained under Payment/Certificate/the Exam Information on Page 2 section of this Registration/Enrollment Agreement. I have read and understand this Registration/Enrollment Agreement and agree with the terms set forth therein. By signing below, the student agrees to pay Phlebotomy Training Specialists (“school”) the total stated tuition & fees. The school agrees to provide the occupational training in accordance with the provisions of the school’s current Catalog Volume No. 5 11 January 2018 2021 (“Catalog”). Payment of all monies due shall be a condition of continuing enrollment. Upon satisfactory completion of all academic and skill requirements and when all financial obligations to the school have been met the school will award the Phlebotomy Technician Certificate to the student. When signed by both parties this document is a legally binding instrument. The student and school understand that this Enrollment Agreement, WHICH INCLUDES THE REFUND POLICY may not be amended except in writing and signed by both parties. A copy of a current school catalog and fully executed copy of this enrollment agreement will be sent via email. Student Signature Date Authorized Representative Date In consideration of the opportunity to receive phlebotomy instruction, training, and other services from Phlebotomy Training Specialists (“PTS”), I agree to the following. Although PTS has taken reasonable steps to make the services provided by PTS safe in an effort to avoid injury, I acknowledge and agree that there are inherent risks of physical injury and other damages associated with phlebotomy instruction and training that remain to exist. These inherent risks include, but are not limited to, injury caused by in-class attempts to draw blood from each other by the participants, like myself, receiving instruction and training from PTS. I understand that the above description of risks associated with the phlebotomy instruction and training is not complete, and that other unknown or unanticipated risks may, however very unlikely, result in injury or death. My participation in phlebotomy instruction and training is purely voluntary, based upon my own assessment of all relevant facts and circumstances, in spite of the associated risks. I acknowledge that I am not relying on any oral, written or visual representations made by PTS, including those made in its brochures or other promotional material, in deciding to voluntarily accept the risks associated with my participation in this phlebotomy instruction and training. I hereby agree to accept the risk of any such injury or damage; in addition I agree not to hold PTS, or any of its owners, employees or agents, responsible in any way for any injuries or damages I may incur during, or related in any manner to, the phlebotomy instruction and training I will receive from PTS, even if PTS or its employees or agents act negligently. I also understand that PTS is neither responsible nor liable for my travel to and from classes. I come and go of my own free will and choice and agree not to hold PTS accountable in any way should I become injured in any manner during those travels. In the event I incur any injury arising from, or related in any manner to, my participation in any phlebotomy instruction or training I receive from PTS, I will immediately notify a PTS instructor of the nature and cause of such injury. I hereby agree to defend, indemnify and hold PTS and its owners, employees and agents harmless from any liability, damages or other costs, including, but not limited to, attorney fees and other costs of litigation, related to, or arising from, my participation in any phlebotomy instruction or training I receive from PTS and/or any of my activities related thereto. The prevailing party in any legal action to interpret and/or enforce any of the terms of this Release of Liability shall also be awarded their reasonable attorney fees and other costs and expenses incurred regarding that legal action. This Release of Liability shall be governed by the laws of the State of Utah. Any dispute between me and PTS shall, upon the written demand of either party, be submitted to arbitration before a single arbitrator whose decision shall be binding and conclusive on all parties. Such arbitration shall generally comply with the arbitration rules of the American Arbitration Association (“AAA”), but need not be conducted or otherwise administered by the AAA, and such arbitration shall be conducted by a provider of arbitration services other than the AAA upon the demand of either party. Such arbitration shall be conducted in the State of Utah regardless of where I received phlebotomy instruction or training and regardless of where I may be located at the time of such dispute. I hereby acknowledge that I have carefully read the above Release of Liability and fully understand its contents. I am aware that I am releasing certain legal rights that I may otherwise have by signing this Release of Liability. In return, I will be allowed to participate in the phlebotomy instruction and training sponsored or conducted by PTS. I have had the opportunity to consult with my own attorney, if I so desired, regarding the meaning and effect of this Release of Liability before I signed it. I now sign this Release of Liability of my own free will and choice. Student Signature Date Printed Name Student Tracking Form Location of Training: Class Start Date: _ State law requires us to track you after graduation. During class at PTS you will be participating in the “Employment Presentation” which covers where to work, how to apply, what to wear, and other resources that correlate to gaining employment. No sooner than 60 days after graduation our staff will begin attempting to contact you by mail, email and phone call/text to ask you questions regarding employment. Sharing this information is arbitrary and you are not required to respond to any of our requests for information. In addition to our employment presentation given during class, we offer resume review. Just send the most recent copy of your resume to xxxx@xxxxxxxxxxxxx.xxx and one of our staff members will review and provide feedback within 72 hours. This form will be used to record the data should you choose to participate in reporting it to us. The collecting of the initial information IS required. Student Name _ Phone # Male Female _ Address City State Zip County SSN (Last 4 digits): Email DOB (MM/DD/YYYY) Are you on disability? Yes No Are you a Veteran? Yes NO Ethnicity: Hispanic/Latino Hawaiian/Pacific Islander Asian Caucasian Native/AlaskanAmerican African American Check all that apply below: I am using the certification to strengthen my resume for my existing medical career. I am currently employed in a health care related field and I am not seeking employment. I am currently employed in a non health care related field and I am not seeking employment. Students should be contacted by phone, mail and email or text message 60-180 days after the student graduates to ascertain whether or not they have gained employment in the field.

STUDENT ACKNOWLEDGMENTS. Student Initial I understand that I must show up to class lucid, and mentally and physically rested and prepared. I understand that if the instructor feels I am not prepared I can be questioned, and if necessary necessary, dismissed from that session with the instruction to be prepared for the next session. Students, who are under the influence of alcohol, elicit illicit drugs, prescription drugs or any other mind or body-altering substances cannot participate in class. Student Initial I understand the Conduct and Dismissal Policy as it is outlined in this agreement. I acknowledge that disruptive behaviorI will be subject to the disciplinary procedures if I am in violation of these policies. Student Initial I authorize Intelvio to contact, vulgar language and request information about me (including, without limitation, date of hire, salary, fulfillment of internship requirements, etc.) from, any employer or inappropriate attire potential employer, or anyone through whom I may, do, or did participate in an internship program. Student Initial I acknowledge that I am responsible for the cost of the full tuition and fees associated with the program. I understand that failure to make consistent payments to the school will result in my account being sent to collections. I also understand that if I withdraw from the program prior to completion, I am financially responsible for the prorated tuition and fees for the classes which I did attend. Student Initial I understand that full tuition and fees are due by the halfway point of class. I acknowledge that if my full tuition and fees are not paid by this time, I will need to follow the Payment Policy found in this agreement. Student Initial I understand that if I fail to complete my initial registered course, reassignment into a new class will not be tolerated during allowed until my entire Tuition balance is paid in full. Students must call Student Services to re-enroll in a new class. If after a warning from an instructor or other PTS staff member the offense continues I may be asked to leave class with out the possible option to return. In this case no refunds Please note that rescheduling will be given. *Scrubs are the preferred attire but are not requiredbased on availability. Student Initial I understand the risks associated with drawing blood, such as contracting diseases and am aware that phlebotomy procedures in class will be performed on fellow students, volunteers volunteers, and staff at Phlebotomy Training Specialists. I also understand that any injury sustained to me or the person I am performing phlebotomy on is solely my responsibility and I will hold Phlebotomy Training Specialists harmless. Student Initial I understand that Phlebotomy Training Specialists does not offer job placement. However, resume assistance is available available, as well as an in in-class discussion on how to obtain and where to look for employment. Student Initial I understand that while PTS will make every effort to hold classes as scheduled, there may be a disruption in projected scheduling due to unforeseen circumstances. I acknowledge that PTS will not make any financial compensations for rescheduling, however, they will also not charge any additional fees for rescheduling. PTS will offer multiple options to complete my course in a timely manner. Should I choose to withdraw from training, the published refund policy will apply. Student Initial I understand that attendance is mandatory to successfully pass this course. Make up class time will be available by contacting student services Student Services only. Student Initial I acknowledge that I will be expected to draw blood on my fellow students, and also that I will have my blood drawn by others. I understand that I will not be able may contact Student Services to schedule or attend make up classes once my registered class has concluded until my tuition is paid in full as explained under General Information on page 2 of this Registration/Enrollment Agreementrequest a medical accommodation. Student Initial I understand that I must log into my student account at xxxxxxxx.xxxxxxxxxxxxx.xxx and check cannot miss the spelling/format first eight hours of my name and that how my name appears here is EXACTLY how it will appear on my certificateclass. I also understand that there is a $15 Fee for Certificate Reprints as explained under Payment/Certificate/Exam Information on Page 2 if I miss any of this Registration/Enrollment Agreementthe first eight hours of class I will be removed from the class and I will be required to select another available class schedule. Student Initial I understand that if I cannot complete the course I originally registered for, before I can be reassigned to another class I must have all tuition paid in fullclass. I also understand that if I need to be reassigned to a class for any reason reason, I must contact student services Student Services to do so. Student Initial I understand the PTS Refund Policy and am aware that all requests to withdraw from the program must be done in writing as explained under General Information on Page 2 in the Cancellation and Refund Policy of this Registration/Enrollment Agreement. Student Initial I understand that I will must send in via email xxxxxxxxx@xxxxxxxxxxxxx.xxx, or fax 000-000-0000 or by upload through my account a copy of my Education Documents. One of the following is required before I can participate in class: Copy of High School Diploma and/or transcripts (transcripts must say OFFICIAL if they do not be able to graduate send us a diploma), Copy of an OFFICIAL GED OR copy of College Transcripts or obtain my certification until I have completed the course and paid ALL tuition in full as explained under Payment/Certificate Information on page 2 of this Registration/ Enrollment AgreementDegree. Student Initial I understand acknowledge that in order to sit for I received a copy of the National Exam, I must have ALL tuition paid in full. I also understand that if I have not paid my National Exam fee at least ONE WEEK prior to the test date I may not be guaranteed a seat or exam on test day as explained under Payment/Certificate/Exam Information on Page 2 of this Registration/Enrollment Agreement. I have read and understand this Registration/Enrollment Agreement and agree with the terms set forth thereinschool’s current Catalog Volume No.12 January 2023 (“Catalog”). By signing below, the student agrees to pay Phlebotomy Training Specialists (“the school”) the total stated tuition & fees. The school agrees to provide the occupational training in accordance with the provisions of the school’s current Catalog Volume No. 5 No.12 January 2018 2023 (“Catalog”). Payment of all monies due shall be a condition of continuing enrollment. Upon satisfactory completion of all academic and skill requirements requirements, and when all financial obligations to the school have been met met, the school will award the Phlebotomy Technician Certificate to the student. The student and school understand that this Enrollment Agreement, WHICH INCLUDES THE REFUND POLICY POLICY, may not be amended except in writing and signed by both parties. A copy This agreement is not binding until accepted by a representative of the school. When signed and dated by both parties this agreement is a current school catalog legally binding instrument. By signing below, the student has read and fully executed copy understands all aspects of this enrollment agreement will be sent via emailEnrollment Agreement. THE STUDENT WILL BE GIVEN A FULLY EXECUTED COPY OF THIS ENROLLMENT AGREEMENT VIA EMAIL ONCE IT HAS BEEN SIGNED. Student Signature Date Authorized Representative Date In consideration of the opportunity to receive phlebotomy instruction, training, and other services from Phlebotomy Training Specialists (“PTS”), I agree to the following. Although PTS has taken reasonable steps to make the services provided by PTS safe in an effort to avoid injury, I acknowledge and agree that there are inherent risks of physical injury and other damages associated with phlebotomy instruction and training that remain to exist. These inherent risks include, but are not limited to, injury caused by in-class attempts to draw blood from each other by the participants, like myself, receiving instruction and training from PTS. I understand that the above description of risks associated with the phlebotomy instruction and training is not complete, and that other unknown or unanticipated risks may, however very unlikely, result in injury or death. My participation in phlebotomy instruction and training is purely voluntary, based upon my own assessment of all relevant facts and circumstances, in spite of the associated risks. I acknowledge that I am not relying on any oral, written or visual representations made by PTS, including those made in its brochures or other promotional material, in deciding to voluntarily accept the risks associated with my participation in this phlebotomy instruction and training. I hereby agree to accept the risk of any such injury or damage; in addition I agree not to hold PTS, or any of its owners, employees or agents, responsible in any way for any injuries or damages I may incur during, or related in any manner to, the phlebotomy instruction and training I will receive from PTS, even if PTS or its employees or agents act negligently. I also understand that PTS is neither responsible nor liable for my travel to and from classes. I come and go of my own free will and choice and agree not to hold PTS accountable in any way should I become injured in any manner during those travels. In the event I incur any injury arising from, or related in any manner to, my participation in any phlebotomy instruction or training I receive from PTS, I will immediately notify a PTS instructor of the nature and cause of such injury. I hereby agree to defend, indemnify and hold PTS and its owners, employees and agents harmless from any liability, damages or other costs, including, but not limited to, attorney fees and other costs of litigation, related to, or arising from, my participation in any phlebotomy instruction or training I receive from PTS and/or any of my activities related thereto. The prevailing party in any legal action to interpret and/or enforce any of the terms of this Release of Liability shall also be awarded their reasonable attorney fees and other costs and expenses incurred regarding that legal action. This Release of Liability shall be governed by the laws of the State of Utah. Any dispute between me and PTS shall, upon the written demand of either party, be submitted to arbitration before a single arbitrator whose decision shall be binding and conclusive on all parties. Such arbitration shall generally comply with the arbitration rules of the American Arbitration Association (“AAA”), but need not be conducted or otherwise administered by the AAA, and such arbitration shall be conducted by a provider of arbitration services other than the AAA upon the demand of either party. Such arbitration shall be conducted in the State of Utah regardless of where I received phlebotomy instruction or training and regardless of where I may be located at the time of such dispute. I hereby acknowledge that I have carefully read the above Release of Liability and fully understand its contents. I am aware that I am releasing certain legal rights that I may otherwise have by signing this Release of Liability. In return, I will be allowed to participate in the phlebotomy instruction and training sponsored or conducted by PTS. I have had the opportunity to consult with my own attorney, if I so desired, regarding the meaning and effect of this Release of Liability before I signed it. I now sign this Release of Liability of my own free will and choice. Student Signature Date Printed Name Student Tracking Form Location of Training: Class Start Date: _ State law requires us to track you after graduation. During class at PTS you will be participating in the “Employment Presentation” which covers where to work, how to apply, what to wear, and other resources that correlate to gaining employment. No sooner than 60 days after graduation our staff will begin attempting to contact you by mail, email and phone call/text to ask you questions regarding employment. Sharing this information is arbitrary and you are not required to respond to any of our requests for information. In addition to our employment presentation given during class, we offer resume review. Just send the most recent copy of your resume to xxxx@xxxxxxxxxxxxx.xxx and one of our staff members will review and provide feedback within 72 hours. This form will be used to record the data should you choose to participate in reporting it to us. The collecting of the initial information IS required. Student Name _ Phone # Male Female _ Address City State Zip County SSN (Last 4 digits): Email DOB (MM/DD/YYYY) Are you on disability? Yes No Are you a Veteran? Yes NO Ethnicity: Hispanic/Latino Hawaiian/Pacific Islander Asian Caucasian Native/AlaskanAmerican African American Check all that apply below: I am using the certification to strengthen my resume for my existing medical career. I am currently employed in a health care related field and I am not seeking employment. I am currently employed in a non health care related field and I am not seeking employment. Students should be contacted by phone, mail and email or text message 60-180 days after the student graduates to ascertain whether or not they have gained employment in the field.

STUDENT ACKNOWLEDGMENTS. Student Initial I understand that I must show up to class lucidhave received and read a copy of The Art Institute of Wisconsin (“The Art Institute”) current catalog, and mentally and physically rested and prepared. I understand that if the instructor feels I am not prepared I can be questioned, and if necessary dismissed from that session with the instruction to be prepared for the next session. Students, who are under the influence of alcohol, elicit drugs, prescription drugs or any other mind or body-altering substances cannot participate either in class. Student Initial I understand that disruptive behavior, vulgar language or inappropriate attire will not be tolerated during class. If after a warning from an instructor or other PTS staff member the offense continues I may be asked to leave class with out the possible option to return. In this case no refunds will be given. *Scrubs are the preferred attire but are not required. Student Initial I understand the risks associated with drawing blood, contracting diseases and am aware that phlebotomy procedures in class will be performed on fellow students, volunteers and staff at Phlebotomy Training Specialists. I also understand that any injury sustained to me printed form or the person online version (xxxx://xxx.xxxxxxxxxxxxx.xxx/flyover/catalogs/138), the provisions of which I am performing phlebotomy on is solely my responsibility and will hold Phlebotomy Training Specialists harmless. Student Initial I understand that Phlebotomy Training Specialists does not offer job placement. However, resume assistance is available as well as an in class discussion on how to obtain and where to look for employment. Student Initial I understand that attendance is mandatory to successfully pass this course. Make up class time will be available by contacting student services only. I understand that I will not be able to schedule or attend make up classes once my registered class has concluded until my tuition is paid in full as explained under General Information on page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I must log into my student account at xxxxxxxx.xxxxxxxxxxxxx.xxx and check the spelling/format of my name and that how my name appears here is EXACTLY how it will appear on my certificate. I also understand that there is a $15 Fee for Certificate Reprints as explained under Payment/Certificate/Exam Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that if I cannot complete the course I originally registered for, before I can be reassigned to another class I must have all tuition paid in full. I also understand that if I need to be reassigned to a class for any reason I must contact student services to do so. Student Initial I understand the PTS Refund Policy and am aware that all requests to withdraw from the program must be done in writing as explained under General Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I will not be able to graduate or obtain my certification until I have completed the course and paid ALL tuition in full as explained under Payment/Certificate Information on page 2 of this Registration/ Enrollment Agreement. Student Initial I understand that in order to sit for the National Exam, I must have ALL tuition paid in full. I also understand that if I have not paid my National Exam fee at least ONE WEEK prior to the test date I may not be guaranteed a seat or exam on test day as explained under Payment/Certificate/Exam Information on Page 2 of this Registration/Enrollment Agreementaccept. I have read and understand all provisions of this Registration/agreement, and I have been given a copy of it for my records. (Parents must also sign if you are under 18 years of age.) I understand that my enrollment and The Art Institute’s obligations under this Enrollment Agreement (except the cancellation and agree refund provisions) may be terminated by The Art Institute if I fail to comply with the terms set forth therein. By signing belowThe Art Institute’s attendance, the student agrees to pay Phlebotomy Training Specialists (“school”) the total stated tuition & fees. The school agrees to provide the occupational training in accordance with the provisions of the school’s current Catalog Volume No. 5 January 2018 (“Catalog”). Payment of all monies due shall be a condition of continuing enrollment. Upon satisfactory completion of all academic and skill requirements and when all conduct, academic, and/or financial obligations to the school have been met the school will award the Phlebotomy Technician Certificate to the student. The student and school understand that this Enrollment Agreement, WHICH INCLUDES THE REFUND POLICY may not be amended except in writing and signed by both parties. A copy of a current school catalog and fully executed copy of this enrollment agreement will be sent via email. Student Signature Date Authorized Representative Date In consideration of the opportunity to receive phlebotomy instruction, training, and other services from Phlebotomy Training Specialists (“PTS”), I agree to the following. Although PTS has taken reasonable steps to make the services provided by PTS safe in an effort to avoid injury, I acknowledge and agree that there are inherent risks of physical injury and other damages associated with phlebotomy instruction and training that remain to exist. These inherent risks include, but are not limited to, injury caused by in-class attempts to draw blood from each other by the participants, like myself, receiving instruction and training from PTSrequirements. I understand that The Art Institute also reserves the above description right to deny my enrollment if The Art Institute determines (i) that I have demonstrated poor academic potential as determined through evaluation of risks associated with transcript records or any other academic evaluations deemed appropriate for the phlebotomy instruction program selected, and/or (ii) that I do not meet all financial obligations related to enrollment and training is not complete, and that other unknown or unanticipated risks may, however very unlikely, result in injury or death. My participation in phlebotomy instruction and training is purely voluntary, based upon my own assessment of all relevant facts and circumstances, in spite of the associated riskscontinuing enrollment. I acknowledge understand that I am not relying on any oral, written or visual representations made by PTS, including those made in its brochures or other promotional material, in deciding my financial obligations PROGRAM PRICING STATEMENT The student is responsible for tuition and fees pertaining to voluntarily accept the risks associated with my participation program’s required course of study. The tuition and fees contained in this phlebotomy instruction and training. I hereby agree Enrollment Agreement are subject to accept the risk of any such injury or damage; in addition I agree not to hold PTS, or any of its owners, employees or agents, responsible in any way for any injuries or damages I may incur during, or related in any manner to, the phlebotomy instruction and training I will receive from PTS, even if PTS or its employees or agents act negligently. I also understand that PTS is neither responsible nor liable for my travel to and from classes. I come and go of my own free will and choice and agree not to hold PTS accountable in any way should I become injured in any manner during those travels. In the event I incur any injury arising from, or related in any manner to, my participation in any phlebotomy instruction or training I receive from PTS, I will immediately notify a PTS instructor of the nature and cause of such injury. I hereby agree to defend, indemnify and hold PTS and its owners, employees and agents harmless from any liability, damages or other costs, including, but not limited to, attorney fees and other costs of litigation, related to, or arising from, my participation in any phlebotomy instruction or training I receive from PTS and/or any of my activities related theretochange. The prevailing party in any legal action per credit hour rate is subject to interpret and/or enforce any of an increase at least once per calendar year which will increase the terms of this Release of Liability shall also total amount for the program. The adjustment to the per credit hour rate may occur before the student begins classes and the student’s program will be awarded their reasonable attorney fees and other costs and expenses incurred regarding that legal action. This Release of Liability shall be governed by calculated using the laws of the State of Utahnew rate. Any dispute between me changes to tuition and PTS shall, upon fees will be published to students. Re-entering students will be subject to the written demand of either party, be submitted to arbitration before a single arbitrator whose decision shall be binding and conclusive on all parties. Such arbitration shall generally comply with the arbitration rules of the American Arbitration Association (“AAA”), but need not be conducted or otherwise administered by the AAA, and such arbitration shall be conducted by a provider of arbitration services other than the AAA upon the demand of either party. Such arbitration shall be conducted in the State of Utah regardless of where I received phlebotomy instruction or training and regardless of where I may be located current per credit hour tuition charge at the time of such disputere-enrollment. I hereby acknowledge that I have carefully read Each school quarter is approximately 11 weeks. An application fee of $50 is to be submitted with the above Release Application for Admission. The enrollment fee of Liability $100 is due within 10 days after the Enrollment Agreement is signed. Special U.S. and fully understand its contentsoverseas trips are voluntary and are not included in regular tuition and fees. I am aware that I am releasing certain legal rights that I may otherwise have by signing this Release of Liability. In returnIf a student elects to enter into a financial plan, I the financial plan will be allowed to participate in compliance with the phlebotomy instruction Federal Truth in Lending installment requirements and training sponsored or conducted by PTS. I have had the opportunity to consult with my own attorney, if I so desired, regarding the meaning and effect will become a part of this Release Enrollment Agreement. The Starting Kits are mandatory for all Culinary programs and optional for all other programs. They consist of Liability before I signed it. I now sign this Release some of Liability of my own free will and choice. Student Signature Date Printed Name Student Tracking Form Location of Training: Class Start Date: _ State law requires us to track you after graduation. During class at PTS you will be participating in the “Employment Presentation” which covers where to workbasic equipment, how to apply, what to wearfirst-quarter textbooks, and other resources that correlate materials needed for beginning each program. A list of the components of the Starting Kit is provided to gaining employmenteach enrolled student. No sooner than 60 days after graduation our staff will begin attempting to contact you by mail, email and phone call/text to ask you questions regarding employment. Sharing this information is arbitrary and you are not required to respond to any of our requests for informationThese materials may be purchased at The Art Institute or at most supply stores. In addition to our employment presentation given during classthe Starting Kit, we offer resume review. Just send the most recent copy average costs of your resume to xxxx@xxxxxxxxxxxxx.xxx consumable supplies, textbooks, and one of our staff members will review and provide feedback within 72 hours. This form will be used to record the data should you choose to participate in reporting it to us. The collecting of the initial information IS required. Student Name _ Phone # Male Female _ Address City State Zip County SSN (Last 4 digits): Email DOB (MM/DD/YYYY) Are you on disability? Yes No Are you a Veteran? Yes NO Ethnicity: Hispanic/Latino Hawaiian/Pacific Islander Asian Caucasian Native/AlaskanAmerican African American Check all that apply below: I am using the certification to strengthen my resume for my existing medical career. I am currently employed in a health care related field and I am not seeking employment. I am currently employed in a non health care related field and I am not seeking employment. Students should be contacted equipment by phone, mail and email or text message 60-180 days after the student graduates to ascertain whether or not they have gained employment in the field.program are as follows:

STUDENT ACKNOWLEDGMENTS. Student Initial I understand that I must show up to class lucid, and mentally and physically rested and prepared. I understand that if the instructor feels I am not prepared I can be questioned, and if necessary dismissed from that session with the instruction to be prepared for the next session. Students, who are under the influence of alcohol, elicit drugs, prescription drugs or any other mind or body-altering substances cannot participate in class. Student Initial I understand that disruptive behavior, vulgar language or inappropriate attire will not be tolerated during class. If after a warning from an instructor or other PTS staff member the offense continues I may be asked to leave class with out the possible option to return. In this case no refunds will be given. *Scrubs are the preferred attire but are not required. Student Initial I understand the risks associated with drawing blood, contracting diseases and am aware that phlebotomy procedures in class will be performed on fellow students, volunteers and staff at Phlebotomy Training Specialists. I also understand that any injury sustained to me or the person I am performing phlebotomy on is solely my responsibility and will hold Phlebotomy Training Specialists harmless. Student Initial I understand that Phlebotomy Training Specialists does not offer job placement. However, resume assistance is available as well as an in class discussion on how to obtain and where to look for employment. Student Initial I understand that attendance is mandatory to successfully pass this course. Make up class time will be available by contacting student services only. I understand that I will not be able to schedule or attend make up classes once my registered class has concluded until my tuition is paid in full as explained under General Information on page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I must log into my student account at xxxxxxxx.xxxxxxxxxxxxx.xxx and check the spelling/format of my name and that how my name appears here is EXACTLY how it will appear on my certificate. I also understand that there is a $15 Fee for Certificate Reprints as explained under Payment/Certificate/Exam Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that if I cannot complete the course I originally registered for, before I can be reassigned to another class I must have all tuition paid in full. I also understand that if I need to be reassigned to a class for any reason I must contact student services to do so. Student Initial I understand the PTS Refund Policy and am aware that all requests to withdraw from the program must be done in writing as explained under General Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I will not be able to graduate or obtain my certification until I have completed received and read a copy of The Art Institute’s current catalog located at xxxx://xxx.xxxxxxxxxxxxx.xxx/flyover/catalogs/11, the course and paid ALL tuition in full as explained under Payment/Certificate Information on page 2 provisions of this Registration/ Enrollment Agreement. Student Initial which I understand that in order to sit for the National Exam, I must have ALL tuition paid in full. I also understand that if I have not paid my National Exam fee at least ONE WEEK prior to the test date I may not be guaranteed a seat or exam on test day as explained under Payment/Certificate/Exam Information on Page 2 of this Registration/Enrollment Agreementaccept. I have read and understand all provisions of this Registration/Enrollment Agreement Agreement, and agree I have been given a copy of it for my records. I accept that, to the extent permitted by law, I am responsible for all reasonable collection agency and attorney fees incurred in attempting to collect any unpaid debts to The Art Institute. If I elect a financial aid plan, the plan will be in compliance with the terms set forth therein. By signing below, the student agrees to pay Phlebotomy Training Specialists (“school”) the total stated tuition & fees. The school agrees to provide the occupational training Federal Truth in accordance with the provisions of the school’s current Catalog Volume No. 5 January 2018 (“Catalog”). Payment of all monies due shall be a condition of continuing enrollment. Upon satisfactory completion of all academic and skill Lending retail installment requirements and when all financial obligations to the school have been met the school will award the Phlebotomy Technician Certificate to the student. The student and school understand that plan becomes a part of this Enrollment Agreement. (Parents or Guardian must also sign if you are under 18 years of age.) I understand that my enrollment and The Art Institute’s obligations under this Enrollment Agreement (except the cancellation and refund provisions) may be terminated by The Art Institute if I fail to comply with The Art Institute’s attendance, WHICH INCLUDES THE REFUND POLICY may not be amended except in writing and signed by both parties. A copy of a current school catalog and fully executed copy of this enrollment agreement will be sent via email. Student Signature Date Authorized Representative Date In consideration of the opportunity to receive phlebotomy instructionconduct, trainingacademic, and other services from Phlebotomy Training Specialists (“PTS”), I agree to the following. Although PTS has taken reasonable steps to make the services provided by PTS safe in an effort to avoid injury, I acknowledge and agree that there are inherent risks of physical injury and other damages associated with phlebotomy instruction and training that remain to exist. These inherent risks include, but are not limited to, injury caused by in-class attempts to draw blood from each other by the participants, like myself, receiving instruction and training from PTSand/or financial requirements. I understand that The Art Institute also reserves the above description of risks associated with the phlebotomy instruction and training is not complete, and that other unknown or unanticipated risks may, however very unlikely, result in injury or death. My participation in phlebotomy instruction and training is purely voluntary, based upon right to cancel my own assessment of all relevant facts and circumstances, in spite of the associated risks. I acknowledge enrollment if The Art Institute determines (i) that I am not relying on any oralhave demonstrated poor academic potential as determined through entrance testing, written or visual representations made by PTS, including those made in its brochures or other promotional material, in deciding to voluntarily accept the risks associated with my participation in this phlebotomy instruction and training. I hereby agree to accept the risk evaluation of any such injury or damage; in addition I agree not to hold PTStranscript records, or any other academic evaluations deemed appropriate for the program selected, and/or (ii) that I do not meet all financial obligations related to enrollment and continuing enrollment. I understand that my financial obligations to The Art Institute must be paid in full before a degree may be awarded and before transcripts will be issued. The Enrollment Agreement and catalog, together with other published The Art Institute policies, procedures, student conduct codes, and separate college-sponsored housing agreement, if any, shall constitute the entire agreement between the student and The Art Institute. I understand and agree that they supersede any prior or contemporaneous oral or written agreements or statements and may not be modified without the written agreement of its owners, employees or agents, responsible in any way for any injuries or damages I may incur during, or related in any manner to, the phlebotomy instruction and training I will receive from PTS, even if PTS or its employees or agents act negligentlyPresident of The Art Institute. I also understand that PTS is neither responsible nor liable for my travel to and from classes. I come and go of my own free will and choice and agree not to hold PTS accountable in any way should I become injured in any manner during those travels. In the event I incur any injury arising from, or related in any manner to, my participation in any phlebotomy instruction or training I receive from PTS, I will immediately notify this Agreement constitutes a PTS instructor of the nature and cause of such injury. I hereby agree to defend, indemnify and hold PTS and its owners, employees and agents harmless from any liability, damages or other costs, including, but not limited to, attorney fees and other costs of litigation, related to, or arising from, my participation in any phlebotomy instruction or training I receive from PTS and/or any of my activities related thereto. The prevailing party in any legal action to interpret and/or enforce any of the terms of this Release of Liability shall also be awarded their reasonable attorney fees and other costs and expenses incurred regarding that legal action. This Release of Liability shall be governed by the laws of the State of Utah. Any dispute between me and PTS shall, binding contract upon the written demand acceptance by The Art Institute. Any holder of either party, be submitted this consumer credit contract is subject to arbitration before a single arbitrator whose decision shall be binding all claims and conclusive on all parties. Such arbitration shall generally comply defenses that the debtor could assert against the seller of goods or services obtained pursuant hereto or with the arbitration rules of the American Arbitration Association (“AAA”), but need not be conducted or otherwise administered proceeds hereof. Recovery hereunder by the AAA, and such arbitration debtor shall be conducted not exceed the amount paid by a provider of arbitration services other than the AAA upon the demand of either partydebtor. Such arbitration shall be conducted in the State of Utah regardless of where I received phlebotomy instruction or training and regardless of where I may be located at the time of such dispute. I hereby acknowledge My signature below signifies that I have carefully read the above Release of Liability and fully understand its contents. I am aware that I am releasing certain legal rights that I may otherwise have by signing this Release of Liability. In return, I will be allowed to participate in the phlebotomy instruction and training sponsored or conducted by PTS. I have had the opportunity to consult with my own attorney, if I so desired, regarding the meaning and effect all aspects of this Release of Liability before I signed it. I now sign Agreement and do recognize my legal responsibilities in regard to this Release of Liability of my own free will and choice. Student Signature Date Printed Name Student Tracking Form Location of Training: Class Start Date: _ State law requires us to track you after graduation. During class at PTS you will be participating in the “Employment Presentation” which covers where to work, how to apply, what to wear, and other resources that correlate to gaining employment. No sooner than 60 days after graduation our staff will begin attempting to contact you by mail, email and phone call/text to ask you questions regarding employment. Sharing this information is arbitrary and you are not required to respond to any of our requests for information. In addition to our employment presentation given during class, we offer resume review. Just send the most recent copy of your resume to xxxx@xxxxxxxxxxxxx.xxx and one of our staff members will review and provide feedback within 72 hours. This form will be used to record the data should you choose to participate in reporting it to us. The collecting of the initial information IS required. Student Name _ Phone # Male Female _ Address City State Zip County SSN (Last 4 digits): Email DOB (MM/DD/YYYY) Are you on disability? Yes No Are you a Veteran? Yes NO Ethnicity: Hispanic/Latino Hawaiian/Pacific Islander Asian Caucasian Native/AlaskanAmerican African American Check all that apply below: I am using the certification to strengthen my resume for my existing medical career. I am currently employed in a health care related field and I am not seeking employment. I am currently employed in a non health care related field and I am not seeking employment. Students should be contacted by phone, mail and email or text message 60-180 days after the student graduates to ascertain whether or not they have gained employment in the fieldAgreement.

STUDENT ACKNOWLEDGMENTS. Student Initial I understand that I must show up to class lucid, and mentally and physically rested and prepared. I understand that if the instructor feels I am not prepared I can be questioned, and if necessary dismissed from that session with the instruction to be prepared for the next session. Students, who are under the influence of alcohol, elicit drugs, prescription drugs or any other mind or body-altering substances cannot participate in class. Student Initial I understand that disruptive behavior, vulgar language or inappropriate attire will not be tolerated during class. If after a warning from an instructor or other PTS staff member the offense continues I may be asked to leave class with out the possible option to return. In this case no refunds will be given. *Scrubs are the preferred attire but are not required. Student Initial I understand the risks associated with drawing blood, contracting diseases and am aware that phlebotomy procedures in class will be performed on fellow students, volunteers and staff at Phlebotomy Training Specialists. I also understand that any injury sustained to me or the person I am performing phlebotomy on is solely my responsibility and will hold Phlebotomy Training Specialists harmless. Student Initial I understand that Phlebotomy Training Specialists does not offer job placement. However, resume assistance is available as well as an in class discussion on how to obtain and where to look for employment. Student Initial I understand that attendance is mandatory to successfully pass this course. Make up class time will be available by contacting student services only. I understand that I will not be able to schedule or attend make up classes once my registered class has concluded until my tuition is paid in full as explained under General Information on page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I must log into my student account at xxxxxxxx.xxxxxxxxxxxxx.xxx and check the spelling/format of my name and that how my name appears here is EXACTLY how it will appear on my certificate. I also understand that there is a $15 Fee for Certificate Reprints as explained under Payment/Certificate/Exam Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that if I cannot complete the course I originally registered for, before I can be reassigned to another class I must have all tuition paid in full. I also understand that if I need to be reassigned to a class for any reason I must contact student services to do so. Student Initial I understand the PTS Refund Policy and am aware that all requests to withdraw from the program must be done in writing as explained under General Information on Page 2 of this Registration/Enrollment Agreement. Student Initial I understand that I will not be able to graduate or obtain my certification until I have completed the course and paid ALL tuition in full as explained under Payment/Certificate Information on page 2 of this Registration/ Enrollment Agreement. Student Initial I understand that in order to sit for the National Exam, I must have ALL tuition paid in full. I also understand that if I have not paid my National Exam fee at least ONE WEEK prior to the test date I may not be guaranteed a seat or exam on test day as explained under Payment/Certificate/Exam Information on Page 2 of this Registration/Enrollment Agreement. I have read and understand this Registration/Enrollment Agreement and agree with the terms set forth therein. By signing below, the student agrees to pay Phlebotomy Training Specialists (“school”) the total stated tuition & fees. The school agrees to provide the occupational training in accordance with the provisions of the school’s current Catalog Volume No. 5 January 2018 (“Catalog”). Payment of all monies due shall be a condition of continuing enrollment. Upon satisfactory completion of all academic and skill requirements and when all financial obligations to the school have been met the school will award the Phlebotomy Technician Certificate to the student. The student and school understand that this Enrollment Agreement, WHICH INCLUDES THE REFUND POLICY may not be amended except in writing and signed by both parties. A copy of a current school catalog and fully executed copy of this enrollment agreement will be sent via email. Student Signature Date Authorized Representative Date In consideration of the opportunity to receive phlebotomy instruction, training, and other services from Phlebotomy Training Specialists (“PTS”), I agree to the following. Although PTS has taken reasonable steps to make the services provided by PTS safe in an effort to avoid injury, I acknowledge and agree that there are inherent risks of physical injury and other damages associated with phlebotomy instruction and training that remain to exist. These inherent risks include, but are not limited to, injury caused by in-class attempts to draw blood from each other by the participants, like myself, receiving instruction and training from PTS. I understand that the above description of risks associated with the phlebotomy instruction and training is not complete, and that other unknown or unanticipated risks may, however very unlikely, result in injury or death. My participation in phlebotomy instruction and training is purely voluntary, based upon my own assessment of all relevant facts and circumstances, in spite of the associated risks. I acknowledge that I am not relying on any oral, written or visual representations made by PTS, including those made in its brochures or other promotional material, in deciding to voluntarily accept the risks associated with my participation in this phlebotomy instruction and training. I hereby agree to accept the risk of any such injury or damage; in addition I agree not to hold PTS, or any of its owners, employees or agents, responsible in any way for any injuries or damages I may incur during, or related in any manner to, the phlebotomy instruction and training I will receive from PTS, even if PTS or its employees or agents act negligently. I also understand that PTS is neither responsible nor liable for my travel to and from classes. I come and go of my own free will and choice and agree not to hold PTS accountable in any way should I become injured in any manner during those travels. In the event I incur any injury arising from, or related in any manner to, my participation in any phlebotomy instruction or training I receive from PTS, I will immediately notify a PTS instructor of the nature and cause of such injury. I hereby agree to defend, indemnify and hold PTS and its owners, employees and agents harmless from any liability, damages or other costs, including, but not limited to, attorney fees and other costs of litigation, related to, or arising from, my participation in any phlebotomy instruction or training I receive from PTS and/or any of my activities related thereto. The prevailing party in any legal action to interpret and/or enforce any of the terms of this Release of Liability shall also be awarded their reasonable attorney fees and other costs and expenses incurred regarding that legal action. This Release of Liability shall be governed by the laws of the State of Utah. Any dispute between me and PTS shall, upon the written demand of either party, be submitted to arbitration before a single arbitrator whose decision shall be binding and conclusive on all parties. Such arbitration shall generally comply with the arbitration rules of the American Arbitration Association (“AAA”), but need not be conducted or otherwise administered by the AAA, and such arbitration shall be conducted by a provider of arbitration services other than the AAA upon the demand of either party. Such arbitration shall be conducted in the State of Utah regardless of where I received phlebotomy instruction or training and regardless of where I may be located at the time of such dispute. I hereby acknowledge that I have carefully read the above Release of Liability and fully understand its contents. I am aware that I am releasing certain legal rights that I may otherwise have by signing this Release of Liability. In return, I will be allowed to participate in the phlebotomy instruction and training sponsored or conducted by PTS. I have had the opportunity to consult with my own attorney, if I so desired, regarding the meaning and effect of this Release of Liability before I signed it. I now sign this Release of Liability of my own free will and choice. Student Signature Date Printed Name Student Tracking Form Location of Training: Class Start Date: _ State law requires us to track you after graduation. During class at PTS you will be participating in the “Employment Presentation” which covers where to work, how to apply, what to wear, and other resources that correlate to gaining employment. No sooner than 60 days after graduation our staff will begin attempting attempt to contact you by mail, email and phone call/text to ask you questions regarding employment. Sharing this information is arbitrary and you are not required to respond to any of our requests for information. In addition to our employment presentation given during class, we offer resume review. Just send the most recent copy of your resume to xxxx@xxxxxxxxxxxxx.xxx and one of our staff members will review and provide feedback within 72 hours. This form will be used to record the data should you choose to participate in reporting it to us. The collecting of the this initial information IS required. Student Name _ Phone # _ Male Female _ Address City _ _ State Zip _ County SSN (Last 4 digits): Email _ DOB (MM/DD/YYYY) Are you on disability? Yes _No Are you a Veteran? Yes NO NO_ _ Ethnicity: Hispanic/Latino Hawaiian/Pacific Islander _ Asian Caucasian Caucasian_ Native/AlaskanAmerican African American Check all that apply below: I am using the certification to strengthen my resume for my existing medical career. I am currently employed in a health care related field and I am not seeking employment. I am currently employed in a non health care related field and I am not seeking employment. I am using the certification to obtain employment in the field of Phlebotomy. Students should be contacted by phone, mail and email or text message 60-180 days after graduation from the program. #1 - Was the student graduates to ascertain whether reached by mail, email, text or not they have phone call? YES NO_ FOR PTS USE ONLY #2 – Has the student gained employment in the field., which they were trained? YES #3 - Has the student gained employment in a field, other than Phlebotomy? YES #4 – Is the student unemployed? YES NO NO