Take the first step. ENROLLMENT Your First Name Your Last Name Your Phone Number Your Email Social Security Number Mailing Address ( No. P.O. Boxes) Mailing Address (City, State, Zip) Did you graduate from high school? YesNo High School High School Address Military Service NoAir ForceArmyCoast GuardMarinesNavy Select a course(s) of interest Clinical Medical AssistantAdministrative Medical AssistantMedical Billing & CodingPatient Care TechnicianPhlebotomy Boot CampPhlebotomyPharmacy Which session do you prefer? MorningAfternoonEveningSaturdaySat & SunOnline PLEASE READ IN ITS ENTIRETY BEFORE SIGNING!! By clicking "SUBMIT" and typing your SIGNATURE in the box below, you are acknowledging that you understand A deposit/registration fee is due within 7 business days of the student receiving notice that he/she has been accepted into the college. If a student requires a refund, 1 on 1 Technical College adheres to the policies set forth by the Alabama Community College System. As such, the college adheres to the following policies: 1. If cancellation occurs within seventy-two (72) hours of enrollment date, all money paid by the prospective student shall be refunded. 2. If cancellations occurs after seventy-two (72) hours of enrollment date, but before classes begin or correspondence material are delivered, a refund shall be made of all money paid except the registration fee. 3. If cancellation occurs after classes begin or after shipment of correspondence materials, a pro rata refund will be made of all unearned prepaid tuition, fees, and charges for books and supplies not issued to the student. Once books and supplies are issued and received by students, these become property of students and refunds may be made only at the discretion of the Director of the college. 4. A full refund is due students whose contracted educational services are denied by the school as a result of economic of academic fraud as defined in the Code of Alabama16- 46-1(7) and (8) (1975). Any course that is eligible for a refund takes up to 30 days of the withdrawal form date. An invoice for the remaining balance will be emailed to you at the email address you provided us with. Please be sure to REVIEW all of the above information for accuracy. You will be contacted shortly to complete the payment process upon receiving this enrollment application. Thank you and we look forward to serving your healthcare training needs. Signature How did you hear about us?