First Name: ______Last: ______

Last four digits of SSN: ______(xxx-xx-1234) only for school identification purposes

Mailing Address: ______Apt/Unit: ______

City: ______State: ______Zip: ______

Email: @

Cell: ______Home: ______

Please read the following course and financial information carefully as this is the official financial and enrollment policy of MARSTE Training Services. Initialing each box indicates that you fully understand the policy. If you have any questions or comments about this policy, please do not hesitate to contact us. Please initial which class/course you are signing up for and note that these tuition fees DO NOT include the required registration fee, The s registration and material fee is due at time of enrollment and is non-refundable. The tuition for each course must be paid before course starts.

Section III.

Tuition / Reg. fee / Program or course / Start Date / Course name
$1,950 / ¨  Blended SUD Program
$410 / ¨  Individual ONLINE Abnormal Psychology Course
$325 / ¨  Individual Blended SUD Courses / 11/25/16 / MTS-02 Law & ethics
$300 / ¨  On line Prevention Course
$180 / ¨  Clinical Supervision
$410 / ¨  Practicum
Code / Name / Starting Enrollment Date / Length
MTS-01 / ¨  Overview of Substance abuse / 8 Weeks (45 hours or 3 Credits)
MTS-03 / ¨  Personal and Professional Development / 8 Weeks (45 hours or 3 Credits)
MTS-04 / ¨  Physiology and Pharmacology / 8 Weeks (45 hours or 3 Credits)
MTS-06 / ¨  Counseling and Theories / 8 Weeks (45 hours or 3 Credits)
MTS-05 / ¨  Case Management / 8 Weeks (45 hours or 3 Credits)
MTS-02 / ¨  Law & Ethics / 11/25/16- 2/8/17 / 8 Weeks (45 hours or 3 Credits)

Please initial each box so that you understand each policy.

¨ MARSTE does not receive any state or federal financial assistance on behalf of students. It is each student’s responsibility to pay tuition, registration and material fees in a timely manner.

¨ Each course must be paid in full before start of class unless otherwise approved by MARSTE TRAINING SERVICES.

¨ Any notification of withdrawal or cancellation must be in writing. There are no refunds. If students do not participate on line for two weeks (14 days) in a row, the student risked being dropped.

¨ MARSTE services does not issue refunds once the course start date has passed. Credit for another course may be issued if deemed appropriate by Executive Director of MARSTE

¨ Completion certificates will not be given until full payment is received. No exceptions.

¨ The cost of registration and course materials will not be reimbursed or discounted.

¨ If full course program is paid in full and a student is dropped or dropped out, the following refund formula will take place.

Ø  Students who have desire to pay for the full SUD program and have completed 60% or more of the courses will not qualify for a refund.

Ø  Students who have completed less than 60 % of the full course will be eligible for a pro rata formula of the tuition fee less any registration or material fee.

¨  Payment of Refunds: If refund is due to an applicant, refund shall be issued by MARSTE administration within 30 business days of determination of applicant status. Registration Fee is nonrefundable.

¨  NOTICE CONCERNING TRANSFERABILITY OF CREDITS AND CREDENTIALS EARNED AT OUR INSTITUTION (MTS). The academic credits you earn at MARSTE Training Services are at the complete discretion of any higher education institution to which you may seek to transfer. MTS is a vocational school and does not transfer credits unless it has a formal agreement with a university or the other institute chooses to accept those credits. .

¨  STUDENTS RIGHT TO CANCEL: You have the right to cancel this enrollment agreement (less registration fee) if:

Ø  1) course has not started;

Ø  2) Per the above refund policy.

¨  To cancel this agreement, the student must provide in writing his or her intent to cancel, with specific date included.

My signature below indicates that I have read, agree and understand the procedures and fees outlined in this agreement. I understand that this is a legally binding contract once signed and accepted by this (MTS) institution.

Applicant Signature: ______Date: ______

MARSTE Authorized Representative: ______Date: ______

Please list any comments or concerns that you would like MARSTE Administration to know.

Print, sign, scan or mail into address below. Please feel free to call with any questions.

MARSTE Training services (MTS) 7227 Broadway Lemon Grove 91945 www.marsteschool.com PH: 619-663-6095 fax 866-255-7359 MTS form revised on 11-11-16 page 1