Student Enrollment Form and Tuition Agreement

Student Enrollment Form and Tuition Agreement

Name:

Address:

Phone #:

Email:

Payment Options:

1Full Tuition$750Save $50

22 Split Payments$400Down payment with enrollment

$400 Held check for 30 days

34 Split Payments$225Down payment with enrollment

$225Held check for 30 days

$225 Held check for 60 days

$225 Held check for 90 days

__Included with my enrollment form is payment for tuition in:

__Cash

__Check made payable to Dr. Val Poll

__Money order made payable to Dr. Val Poll

Signature:

By signing this enrollment form, you acknowledge that you have received, read, understood, and agree to be bound by the terms and conditions on these pages. This enrollment form is not a valid contract until it has been accepted by an authorized representative. As soon as enrollment is processed, you will receive access to the online study materials.

Student’s Signature:Date:

If you are under 18, your parent or guardian must sign below:

Signature of Guarantor:Name of Guarantor:

Relationship to Student:Address of Guarantor:

Included with tuition:

1Online access to program study materials, videos, progress tracker, online unit exams and mentoring.

2Supplies for wet labs, for hands on instruction held at Coldwater Animal Hospital.

3Issuance of a certificate upon completion of CVA Program and financial obligation.

4Resume review, mock job application and mock interview.

5Distribution of final resume to area hospitals and other related animal care facilities.

Graduation:

You are allowed up to 3 months to complete the online portion of the program. You have an additional 4 months to complete the 90 day externship. You may request two paid one month extensions as long as the program is completed within 9 months. Each extension is $75 per month. We reserve the right to academically cancel any student who does not demonstrate satisfactory progress.

Volunteer Policy for Coldwater Animal Hospital:

I realize that as a volunteer at Coldwater Animal Hospital, I do not act as a representative for the hospital and I am not entitled to monetary compensation. I know that I have a responsibility to make a good impression to clients and will abide by the code of conduct and appearance within the volunteer policy.

__I have received a copy of the volunteer policy and agree to its terms.

Signature:

CVA Credential through TVMA:

If a student wishes to receive the CVA credential through the Texas Veterinary Medical Association (TVMA), they can take the test once the necessary skills evaluations and volunteer hours have been completed.

The additional cost to the student is $125.

The test can be retaken for $35.