Enrollment Form for Coaching Pros for Personal Injury, LLC

Complete the following info and submit.

Student’s Name Student’s Name * First Last
Time Time * : HH MM AM/PM
Interviewer Name Interviewer Name * First Last
Address Address *
Street Address
Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone * - ### - ### ####
Email *
Date of Birth Date of Birth * / MM / DD YYYY
How did you hear about us?
Is the student a minor? *

Is the student a minor? Yes No
Legal Guardians Info
Legal Guardians Name Legal Guardians Name * First Last
Address
(Legal Guardian) Address
(Legal Guardian) *
Street Address
Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone
(Legal Guardian) Phone
(Legal Guardian) * - ### - ### ####
Email
(Legal Guardian) *
Student Information
High School
Graduation Year
School
Degree
Years Attended
School
(Option 2)
Degree
(Option 2)
Years Attended
(Option 2)
Work Experience
Job
Title
Start Date
End Date
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Coaching Pro's admits students of any race, color, religion, Creed, gender, disability, National or ethnic origin, sexual orientation or any other protective class. We carry out educational activities, admission policies, and employment policies in compliance with local, state, and federal law.

The terms and conditions of being accepted to participate in Coaching Pro's program are as follows.

1.) Once enrolled in the program student agrees and acknowledges that they will not miss any sessions. There will be an additional fee of $150 for each Makeup Session required.
2.) Coaching Pro's will not disseminate hard copy materials. Student will be provided with copyright-protected manuals on a disk drive they made download for free. Students understand this manual may only be used for education purposes and not for resale. If a student wants a hard copy of the manual it will be by written request for an additional fee of $150.
3.) Payment by student must be paid in full before first class starts.
4.) Coaching Pro's will assist student in job placement after successful completion of the course but does not guarantee it.
5.) Coaching Pro's will administer an extensive test at the end of classes. Students will not be allowed to take this home. We keep the original in our files so that we can foster job placement. If the student wants a copy of the test one will be provided, but student must pay the copying expenses, which will be determined on an individual basis.
Date
Auto filled Date
Auto filled * / MM / DD YYYY
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Enrollment Form for Coaching Pros for Personal Injury, LLC

Enrollment Form for Coaching Pros for Personal Injury, LLC

Legal Guardians Info

Student Information

Work Experience