Enrollment Agreement Date: 00 - 00 - 0000 PLEASE PRINT OR TYPE ☐ New Student ☐ Re-Entry Student Applicant Legal Name: (First) (Middle) (Last) Social Security #: 000 - 00 - 0000 Date of Birth: 00 - 00 - 0000 Driver’s License /ID No.: Home Telephone: (...January 8th, 2019
FiledJanuary 8th, 2019A Certificate of Completion will be issued after the certification of the training program and all tuition fees are paid in full or otherwise accounted for.