* Required Information

A: STUDENT INFORMATION

B: COURSE INFORMATION

C: METHOD OF PAYMENT

(For Checks and Money Orders, please make payment payable to Barnabas Health Care School of Professional Studies)

Payment of enrollment fee constitutes certification that the information on this enrollment form is correct, that the refund policy (all tuition and fee paid by the applicant shall be refunded if the applicant is rejected by the school or if applicant requested for refund within three business days after signing a contract with the school. No refund will be made after the end of the 3rd class day. The only exception to this policy will be for military service, death in immediate family, serious illness or hospitalization. A written request for exception to the refund policy must be submitted to the Administrator's office within 5 days of last class attendance. All refunds shall be refunded within 30 days) is understood, and that the rules and regulations in the Barnabas Health Care School of Professional Studies catalog have been read and will be abided by:

(If Student is less than 18 years)