Central Business School

Licensed by the Michigan Department of Energy,
Labor, and Economic Growth since 1994

Enroll

Central Business School Health Information Technology
Certificate Program Enrollment Form (below)
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For the Health Information Coding Certificate Program
Enrollment Form - Follow this link

Applicant Name

 

Address

 

City, State, Zip

 

Phone

 

Email Address

 

Date of Birth

 

Social Security Number

 

PLEASE SELECT YOUR CERTIFICATE PROGRAM CHOICE(S):

FULL PAYMENT WITH ENROLLMENT
RECEIVE 5% DISCOUNT ON PROGRAM AND BOOK COSTS:

________             Medical Terminology (MTRM200) - $995 plus $319 for book package (add $30.00 for shipping) - total - $1344 – discount $67 - you pay $1277

________             Human Anatomy (HANA200) - $995 plus $167 for book package (add $30 for shipping) - total $1192 – discount $60 - you pay $1132

________             Medical Transcription (MTRN300) - $995 plus $352 for book package (add $30.00 for shipping) - total - $1377 – discount $69 – you pay $1308

________             Medical Records Coding (MCOD400) - $995 plus $556 for book package (add $30.00 for shipping) - total - $1581- discount $79 - you pay $1502

 

Tuition Agreement: 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 course. Certificate and transcript are also awarded upon successful completion of the Health Information Coding Certificate Program.  Allowable completion time for each course: 18 weeks from date of enrollment.  No payment plan is available for the Health Information Coding Certificate Program.  Complete the courses in order of your choice and pay for each course separately.
Check#/Money Order#:
 
My signature here acknowledges that
I have read and understood the tuition
agreement above
Please mail enrollment form to:
Central Business School
PO Box 1081
Marquette, MI 49855

 

CENTRAL BUSINESS SCHOOL
 PAYMENT PLAN
HEALTH INFORMATION TECHNOLOGY PROGRAMS 

INITIAL PAYMENT DUE WITH ENROLLMENT.  FINAL PAYMENT DUE WITHIN NINE WEEKS OR NINE LESSONS  (WHICHEVER COMES FIRST) 

INITIAL PAYMENT:

________             Medical Terminology (MTRM200) – Initial payment: $846.50.  Final payment: $497.50

________             Human Anatomy (HANA200) - Initial payment: $694.50.  Final payment: $497.50

________             Medical Transcription (MTRN300) - Initial payment: $879.50.  Final payment: $497.50

________             Medical Records Coding (MCOD400) - Initial payment: $1083.50.  Final payment: $497.50

PAYMENT PLAN:

I agree that I am now paying for ½ of the course cost plus the full cost of books and shipping.  I agree to pay the remaining ½ of the course cost within nine weeks or nine lessons (whichever comes first).

Signature:

Date:

Amount Enclosed:

Check #/Money Order #:

Please mail this form, your enrollment form, and your check or money order to:

                Central Business School

                PO Box 1081

                Marquette, MI 49855

THANK YOU!

 

 

NOTICE OF CANCELLATION

(Enter date of transaction)

Date:

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:

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Signature  
Date