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REGISTRATION FORM

Healthcare Education, LLC
2526 Lusher Road
St. Louis, MO 63138
314-653-8863

Date:

(MM/DD/YYYY)

Term: Fall/Winter/Spring/Summer

Student Information

MAIN REGISTRATION FORM

  • Price: $375.00
  • Ethnic Group: African American/Black, American Indian/Alaska Native, Hispanic/Latino, Asian/Pacific Islander, Caucasian/White (circle one)
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Tuition Payment Policy

75 % refund of tuition only if completed 0 – 10% of program
clock hours 50% refund of tuition only if completed 11 – 25% of
program clock hours 25% refund of tuition only if completed 26
– 50% of program clock hours 0% refund if completed more than
50% of program clock hours. There will be no refund on the
upfront $375 registration fee after the cancellation period. There
will also be no refund on, no call no show students.

To assist students in fulfilling the financial obligations required to pay for the courses,
all courses fall under the payment plan as outlined in the following steps below, with
the last payment having a (6%) six percent interest charge if not paid on time:

CNA AND EKG TECHNICIAN

  • $300 due at registration plus a $75 registration fee
  • $300 due on the first day of class
  • $300 due two weeks after start date

NO EXCEPTIONS

PATIENT CARE TECHNICAIN & Hybrid

  • $300 due at registration plus a $75 registration fee
  • $350 due on the first day of class
  • $350 due every two weeks until paid in full

NO EXCEPTIONS

PHLEBOTOMY & Hybrid

  • $300 due at registration plus a $75 registration fee
  • $300 due on the first day of class
  • $300 due two weeks after start date

NO EXCEPTIONS

MEDICAL BILLING & CODING AND PHARMACY TECHNICIAN

  • $300 due at registration plus a $75 registration fee
  • $350 due on the first day of class
  • $350 due every two weeks until paid in full

NO EXCEPTIONS

MEDICAL ASSISTANT & Hybrid

  • $300 due at registration plus a $75 registration fee
  • $350 due on the first day of class
  • $350 due every two weeks until paid in full

NO EXCEPTIONS

I have read all the above information and understand that I am responsible for any outstanding balance that I may incur at Healthcare Education, LLC. I also agree by signing this registration form that Healthcare Education, LLC may use any photos and videos that are taken at the school may be used for any type of brochures or advertisements that they decided to do

High School Diploma/HISET Attest

I, attest that I have a high school diploma/HISET. I graduated from, high school in By signing I am guaranteeing that this is a true and accurate statement.

Juliet M Crowder

Healthcare Education, LLC

Owner/CEO

314-653-8863