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| Applicant
Name: |
Date of Birth: |
| Street
Address: |
Soc. Sec. #: |
| City,
State, Zip |
E-mail address: |
| Phone: |
Employer: |
PLEASE SELECT YOUR PROGRAM CHOICE
(MTRM200, HANA200, MTRN300, MCOD400)
(prices for book packages listed below):
CORRESPONDENCE PROGRAM PRICES:
Receive 5% discount
on program and book costs when you make full payment with your enrollment!
_____ Medical Terminology (MTRM200) - $1295
plus $319 for book package (add $30.00 for shipping) - $1644 less discount $83 - Total $1561
_____ Human Anatomy (HANA200) - $1295
plus $167 for book package (add
$30.00 for shipping) - $1492 less discount $75 - Total - $1417
_____ Medical Transcription (MTRN300)- $1295 plus $522
for book package (add $30.00 for shipping) - $1847 less discount $92 - Total - $1755
_____ Medical Records Coding (MCOD400) - $1295
plus $556 for book package (add
$30.00 for shipping) - $1881 less discount $94 - Total - $1787
PAYMENT PLANS FOR CORRESPONDENCE PROGRAMS:
INITIAL PAYMENT DUE
WITH ENROLLMENT.
FINAL PAYMENT DUE WITHIN NINE WEEKS OR NINE LESSONS (WHICHEVER COMES FIRST)
____ Medical Terminology
(MTRM200) - Initial payment - $996.50
____ Medical Terminology (MTRM200) -
Final payment - $647.50
____ Human Anatomy (HANA200) -
Initial payment - $844.50
____ Human Anatomy (HANA200)-
Final payment - $647.50
____ Medical Transcription
(MTRN300)- Initial payment - $1199.50
____ Medical Transcription
(MTRN300)- Final payment - $647.50
____ Medical Records Coding (MCOD400) -
Initial payment - $1233.50
____ Medical Records Coding
(MCOD400) - Final payment - $647.50
CHECK or MONEY ORDER ENCLOSED: ______________
CREDIT CARD INFORMATION:
____________________________ (number)
______________ (exp.)
PLEASE MAIL TO: CENTRAL BUSINESS SCHOOL
PO BOX 1081
MARQUETTE MI 49855
Please allow three weeks for Central Business School to
process your order. For questions, e-mail
cbsinfo@upfirst.com
or call (906) 226-5270.
APPLICANT SIGNATURE: ____________________________
DATE: ____________________________
My
signature here acknowledges that I have read and understood the "Tuition
Agreement #1" below.
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Tuition Agreement #1:
The
certificate program packages are assembled at the time of the order to provide
the student with the most current materials. Please allow 2 to 3 weeks for your
program package to be ready for shipment. All enrollments are confirmed by
email or phone call. All tuition and fees paid by the applicant shall be
refunded if the applicant is rejected by the school before enrollment. An
application fee of not more than $25.00 may be retained by the school if the
application is denied. All tuition and fees paid by the applicant shall be
refunded if requested within three business days after signing a contract with
the school. All refunds shall be returned in 30 days. Certificate and
transcript are awarded upon successful completion of each program. Allowable
completion time: One year from date of enrollment.
Full payments reflect a 5% discount on
program and book prices.
Payment plan available on
most programs -
pay as little as 50% of program cost
plus books to get started.
Make the initial half payment plus book costs and receive the entire program package.
Pay the remaining 50% of the
program
cost within 9 weeks or at completion of Lesson 9 (1/2 of the program), whichever comes
first.
Certificate and transcript awarded upon successful completion of each
certificate program.
Free
job-seeking assistance
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View the
Central Business School
Health Information Coding Certificate Program
Enrollment form
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