Open Enrollment Registration Form

Please complete the form below to register for an open enrollment program. All fields marked with an asterisk are required. You are not enrolled in the program until payment is received.

 

Upon submitting this form, you will receive a welcome email and invoice within 1 week.

Applicant Information


Contact Information


Emergency Contact Information


Program Information

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Billing Information


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Terms and Conditions of Registration:
Your attendance requires significant advance preparation. We must receive all requests to cancel or transfer in writing according to the policies stated below.

Cancellation Policy:
30 days or more before the program start date: full refund or no fee if invoice unpaid.
Less than 30 days before the program start date: 50% refund or charged 50% of program fee if invoice still unpaid.
Cancellations or no-shows on or after the program start date: no refund or charged 100% of program fee if invoice still unpaid.

Transfer Policy:
30 days or more before the program start date: no transfer fee and program fee invoice moved to new due date.
Less than 30 days before the program start date: $500 transfer fee plus any increase in the program cost if applicable (both due immediately via credit card) and program fee invoice moved to new due date.

Purchase Orders:
The individual participant is ultimately responsible for payment of invoice. If your company wants to issue a Purchase Order for payment of invoice, a personal credit card must be given as a guarantee to complete your enrollment. If the Purchase Order has not been paid by invoice date a 5% fee will be added to the invoice and the credit card will be charged. The credit card charge less the 5% fee will be refunded when purchase order payment has been received.



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