New Student Registration

Name *

First

Middle

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Phone *

Date of Birth *

State Certification Questions

The following questions are on the State Certification Registration Form. Failure to answer these questions will prevent you from registering for this course. Answering "Yes" to any of the questions does not necessarily mean you cannot be certified. Express Training Services, LLC wants to make sure you can be certified by the state. That is why these questions are asked before you take this course.

Do you have a High School Diploma or its equivalent (GED)? *

Yes
No

Do you have a valid Social Security Number? *

Yes
No

Have you ever taken the state certification exam? *

Yes
No

Have you ever been convicted of, or entered a plea of guilty, nolo contendere, or no contest to, a crime in any jurisdiction other than a minor traffic offense? You must include all misdemeanors, felonies, and juvenile offenses, even if adjudication was withheld. Driving under the influence (DUI) or driving while impaired (DWI) is not a minor traffic offense for purposes of this question. *

Yes
No

Have you ever been denied or is there now any proceeding to deny your application for any healthcare certification to practice in Florida or any other state, jurisdiction or country? *

Yes
No

Have you ever had disciplinary action taken against your certification to practice any healthcare-related profession by the licensing authority in Florida or in any other state, jurisdiction or country? *

Yes
No

Have you ever surrendered a certification to practice any healthcare-related profession in Florida or in any other state, jurisdiction or country while any such disciplinary charges were pending against you? *

Yes
No

Do you have any disciplinary actions pending against your certification? *

Yes
No

$100 Deposit Required - To enroll in the following classes: *

CNA
Phlebotomy
Medical Assistant

If you have no prior medical experience or have not taken medical classes start with Certified Nursing Assistant "CNA". CNA is a pre-requisite for the Medical Assistant or Phlebotomy class. You cannot take Phlebotomy if you do not have prior medical experience or have coursework in medical classes.

No Deposit Required - To enroll in the following classes:

CPR
First Aid

Questions or Comments?

Class Registration Deposit *

Price: $ 100.00

A deposit is required to hold your spot in a class, with the balance due the first day of class. The deposit is non-refundable and non-transferrable.

Credit Card Payment *

Card

Name on Card

Terms of Service *

I have read and accept the terms of service below

Enrollment Agreement

Cancellation and Refund Policy:

Tuition
Should a student be terminated or cancel for any reason, all refunds will be made according to the following refund schedule:

Cancellations must be made in person or by certified mail. All monies will be refunded if the school does not accept the applicant.

If the student cancels within three (3) business days after signing the enrollment agreement, and the class start date is more than three (3)business days away, all monies will be refunded with the exception of the $100 registration fee. If the student cancels or withdrawals after the program has begun, no refund will be issued. All refunds will be made within 30 days of termination or receipt of cancellation notice.

Textbook and Registration Fees
No refunds will be given on a textbook that has been written in, marked, or otherwise damaged. If the textbook is in good condition, a refund will be made according to the tuition refund rules. A registration fee of $100 is included as part of the total price. The registration fee is non-refundable under any circumstances.

Package Deals
There are some classes that offer a “package” deal. This means multiple services are lumped together and provided at one price. Refunds of a package deal will be made using the “Individual Fees” for the refund amounts. The refunds will be made for the state certification exam first, followed by textbooks, uniforms, registration fees, and lastly tuition. The total refund amount will never exceed the fee paid.

State Certification Exam Fee
In accordance with testing company policy, there are no refunds for state certification fees. Once fees are submitted for the state certification fee, which occurs on the first day of class, it is the student’s responsibility to obtain a refund from the testing company.

Rescheduling
Class start dates must be selected at the time of registration. Class start dates can be changed with one week’s notice. The only time a class date can be changed with under one week’s notice is if there is a documented emergency.

Class Cancellation
A full refund of all fees paid will be made for classes that are canceled regardless of length. The refunds will be made to the appropriate agency or student as prescribed above.

Deposits
A deposit may be submitted to hold your seat in a class. The deposit is non-refundable under any circumstances. The only way to get a refund for tuition, exam fees, etc. is to pay all the money owed prior to cancellation. Deposits must be via credit card, cash, or money order. If a deposit is made, the balance of the money is due no later than the first class session. If the balance is not paid, a student may be removed from the class and forfeit their deposit.

Healthcare Courses

CNA Classes Available

State Certification Questions