Common Contracts

2 similar Enrollment Agreement contracts

Contract
Enrollment Agreement • November 29th, 2018

DATS of Maryland is approved to operate by Contact us at: DATS of Virginia is certified to operate by Maryland Higher Education Commission (MHEC) 877-777-8719 State Council of Higher Education for Virginia (SCHEV) ENTRY-LEVEL DENTAL ASSISTANT ENROLLMENT AGREEMENT I hereby apply for enrollment in DATS, Inc., hereinafter referred to as “School”. A representative has provided me with a catalog and explained the program and terms of the Enrollment Application. Return by Fax to 855-328-7123 SCHOOL Location: Session: APPLICANT INFORMATION Last Name: First Name: MI Date of birth: Gender: SSN: Street address: Email: City: State: ZIP Code: Cell Phone: Home Phone: Work Phone: EMPLOYMENT INFORMATION Employer: Position: How long? Employer address: Phone: City: State: ZIP Code: EMERGENCY CONTACT Name: Relationship: Address: Phone: City: State: ZIP Code: EDUCATION Name of School Last Attended: Date Last Attended: Highest Level Achieved: MARKETING How did you hear about us: CLASS AND TUITION INFORMA

Contract
Enrollment Agreement • October 26th, 2017

DATS of Maryland is approved to operate by Contact us at: DATS of Virginia is certified to operate by Maryland Higher Education Commission (MHEC) 877-777-8719 State Council of Higher Education for Virginia (SCHEV) ENTRY-LEVEL DENTAL ASSISTANT ENROLLMENT AGREEMENT I hereby apply for enrollment in DATS, Inc., hereinafter referred to as “School”. A representative has provided me with a catalog and explained the program and terms of the Enrollment Application. Return by Fax to 855-328-7123 SCHOOL LOCATION □ ANNAPOLIS 2623 Housley Rd, Annapolis MD 21401□ COLUMBIA 10630 Little Patuxent Parkway, Suite 410, Columbia MD, 21044 □ GERMANTOWN 19512-A Amaranth Dr, Germantown MD, 20874□ WESTMINSTER 412 Malcolm Dr, Westminster, MD, 21157 Session: □Winter (February 2018) □Spring (May 2018) □Fall (September 2018) APPLICANT INFORMATION Last Name: First Name: MI Date of birth: SSN: Email Street address: City: State: ZIP Code: Cell Phone: Home Phone: Work Phone: EMPLOYMENT INFORMATION Employer: Position: