Central Business School
Licensed by the Michigan Department
of Energy, Labor & Economic Growth since 1994


Central Business School

 

Health Information Technology Certificate Programs
Enrollment Form
Printer-Friendly Version

For Health Information Coding Certificate Program
Enrollment Form - follow this link

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) - $995 plus $319 for book package (add $30.00 for shipping) - $1344 less discount $67
Total - $1277
_____ Human Anatomy  (HANA200) - $995 plus $167 for book package (add $30.00 for shipping) - $1192 less discount $60
Total - $1132
_____ Medical Transcription (MTRN300)- $995 plus $352 for book package (add $30.00 for shipping) - $1377 less discount $69
Total - $1308
_____ Medical Records Coding (MCOD400) - $995 plus $561 for book package (add $30.00 for shipping) - $1586 less discount $79
Total - $1507

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 - $846.50
____ Medical Terminology (MTRM200) - Final payment - $497.50
____ Human Anatomy (HANA200) - Initial payment - $694.50
____ Human Anatomy (HANA200)- Final payment - $497.50
____ Medical Transcription (MTRN300)- Initial payment - $879.50
____ Medical Transcription (MTRN300)- Final payment - $497.50
____ Medical Records Coding (MCOD400) - Initial payment - $1088.50
____ Medical Records Coding (MCOD400) - Final payment - $497.50

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 Central Business School.

APPLICANT SIGNATURE: ____________________________
DATE: ____________________________

My signature here acknowledges that I have read and understood the "Tuition Agreement" below.

Tuition Agreement:

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

NOTICE OF CANCELLATION

Enter date of transaction:                                                     

You may cancel this transaction, without penalty or obligation, within 3 business days from the above date.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice.

I hereby cancel this transaction:

Name

 

 

Signature

 

 

Date

 

 


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