Enrollment Agreement Location(Required)New JerseyNew YorkVirginiaChoose training center location.Name(Required) First Last Last 4 SSN(Required) DOB(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone(Required)Email(Required) Program InformationAdmission to classes is on a rolling basis and training sessions are 2 hours each day except when noted. A student can register for a class on any operating day of the school and begin classes on a Monday. Our facility is open from 8:30am – 8:00pm Monday-Friday & Saturday from 9:15am – 3:15pm. Due to the Pandemic all classes are Virtually Instructor-Led.Payment Method(Required) WIOA Training Voucher Self Pay Gift Certificate There is a non‐refundable registration fee of $100.00. This fee is not part of tuition. The tuition will cover the entire program. The student is responsible for 100% percent of the total tuition payable on or before the first day of class (except if the student has a training voucher). All tuition monies paid by the student will be refunded if the applicant cancels this contract within three (3) business days from the date of signing. This refund, less the registration fee, is applicable even if instruction has begun.Course Name Start DateMonth123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Course Fees Course Name Amount Level Microsoft Word Associate $295.00 Any Level Microsoft Word Expert $295.00 Any Level Microsoft Excel Associate $295.00 Any Level Microsoft Excel Expert $295.00 Any Level Microsoft PowerPoint $295.00 Any Level Microsoft Outlook $295.00 Any Level Microsoft Publisher $295.00 Any Level Microsoft Visio $295.00 Any Level Accounting Assistant w/AI $4,000.00 180 Hours Executive Assistant w/AI $4,000.00 200 Hours Administrative Assistant w/AI $4,000.00 200 Hours Legal Secretary/Assistant w/AI $4,200.00 200 Hours Financial Support Worker w/AI $4,200.00 200 Hours Legal Support Worker w/AI $4,200.00 200 Hours Typing $300 35 Hours COMPLAINT RESOLUTION POLICYStudents must submit written complaints to the school director within 3 days of event. The school director will notify the student, in writing, within 3 days of written complaint of the procedures that the student and administration will follow when resolving the student’s concerns.REFUND POLICYHolt Computer Training refund policy is based on full‐time attendance in courses/programs exceeding 300 hours, but not exceeding 1200 hours (N.J.A.C. 12:41‐4.1). The school may retain the registration fee and a portion of the monies paid for books, equipment, and tools. The director of the school must be notified in writing within five (5) business days of the date of withdrawal. The school shall adhere to the following refund policy in the event of notification by the student of withdrawal from the school or termination by the school prior to completion of the course or program:Time of WithdrawalWithin three business days of signing this contract During the first week Weeks two and three After three weeks and prior to 25% After 25% of program and before 50% After 50% of program is completedWIOA Training VoucherVoucher # Counselor Name Counselor Phone #One Stop Location CertificationMicrosoft or Intuit testing and/or professional credential(s) will be available upon completion of the training program(s). The student agrees to maintain regular attendance and to abide by the rules and regulations of the school. The student understands that regular attendance is the obligation of the student and the school’s policy regarding absence and make‐up as stated in the school catalog will apply. Violation of school rules and regulations may subject the student to dismissal. Holt Computer Training School’s post‐training placement information is available at www.njtopps.com. In the event of an unannounced school closure, students enrolled at the time of the closure must contact the Department of Labor and Workforce Development’s Training Evaluation Unit within ninety (90) calendar days of the closure. Failure to do so within the ninety (90) days may exclude the student from any available form of assistance. The contact number to call is (609)292‐4287. The student acknowledges receiving a copy of this agreement, the school catalog, and written confirmation of acceptance prior to signing this contract. The student, by signing this contract, acknowledges that he/she has read this contract and understands the terms and conditions and agrees to the conditions outlined in this contract. Signing of this contract by the school is written confirmation by the school that the above-named student has been approved to enter the above-named program(s). This agreement is not binding until three business days after signing by both parties. The student and the school shall retain a copy of this agreement.Signature(Required)Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920PhoneThis field is for validation purposes and should be left unchanged.