HIFE CCP Enrollment Options Application

HIFE Enrollment Options Application
Please select which CCP Program Option(s) you would like to enroll in? (You can select as many options that you need!)
Package 1:

Career Assessment and Guidance
Package 2:

College Selection and Admissions Guidance
Package 3:

Financial Aid Guidance
Package 4:

Application and Essay Review
Package 5:

Post High School Planning
*We've noticed that you have chosen all 5 Options and wanted to let you know that it might be best to try our Full Program for $2,695 (a savings of $103 over choosing all packages above!). If interested please CLICK HERE for that enrollment form, otherwise feel free to continue. Thanks!
FAMILY PROFILE
Section 1: Student's Information
First and Middle Name:*
Last Name:*
Do you go by a different name/ nick name?
Grade Level:*
Student's Gender
School Level:*
Date of Birth:*
Address:
City:
State:
Zip:
Home Phone:
Mobile Phone:
Student's Email Address:*
Student's Resident Status*

Section 2: Student's Goals
What would you like gain from the Career Assessment and Guidance program (please be as specific as possible so that our coach can best serve your goals) :*
What would you like gain from the College Selection and Admission Guidance program (please be as specific as possible so that our coach can best serve your goals) :*
What would you like gain from the Financial Aid Guidance program (please be as specific as possible so that our coach can best serve your goals) :*
What would you like gain from the Application and Essay Review program (please be as specific as possible so that our coach can best serve your goals) :*
What would you like gain from the Post High School Planning program (please be as specific as possible so that our coach can best serve your goals) :*

Section 3: Parent Information
Father's First Name:
Mother's First Name:
Father's Middle Initial:
Mother's Middle Initial:
Father's Last Name:
Mother's Last Name:
Father's Home Phone:
Mother's Home Phone:
Father's Mobile Phone:
Mother's Mobile Phone:
Father's Email Address:*
Mother's Email Address:*

Section 4: Consultant Information
Did a HIFE College Consultant assist on this enrollment?

YesNo
Thank you for letting us know. Please continue to the next page.
Consultant Name:
Consultant's Office Address:
Consultant's City:
Consultant's State:
Consultant's Zip:
Consultant Phone Number:
Consultant's Email Address:*
If you are a certified HIFE College Consultant, are you also with World Financial Group (WFG), World System Builder (WSB) or Transamerica Financial Advisors (TFA)?*
WFG Agent Code:*
Upline SMD:
SMD Code #:
Upline CEO:
CEO Code #:
Financial Center:

The Heartland Institute Pledge
Through our “College Coaching” guidance and preparation for a successful college education, the Heartland Institute of Financial Education commits to provide “excellence in guidance” for the following areas:
Package 1: Career Assessment and Guidance
- Kuder account
- Access to the Career Interest, Skills Inventory, and Work Values Assessments
- Four - 30 minute virtual Career Coaching session with a HIFE Coach:
  - Explore how to use Kuder functionality
  - Review assessment results
  - Discuss assessment recommendations
  - Provide personalized recommendations for student to create plan to
    research and decide upon career path and corresponding major
- Package 2: College Selection and Admissions Guidance
  - Kuder account
  - Access to the Career Interest, Skills Inventory, and Work Values Assessments
  - Explore how to use Kuder functionality
  - Access to the College search/comparison functionality
  - Discuss how to navigate and find schools that match their needs and profile
  - Four - 30 minute virtual College Selection Coaching sessions with a HIFE Coach
    
    Provides a list of relevant questions for families and students to ask during college visits. This list helps to prioritize colleges for final consideration and ultimate choice.
    
    Discuss the college selection process, factors to consider, strategies for narrowing down college choices
    
    Discuss the college application process, provide suggestions to keep student on track for all deadlines
    
    Discuss importance of essays and provide resources on how to best write essays
    
    Provide guidance on how to navigate choosing the school to attend (based upon acceptance) Talk through how to make the best decision for the student
- Package 3: Financial Aid Navigation
  - Kuder account
  - Access to the Career Interest, Skills Inventory, and Work Values
  - Assessments
  - Explore how to use Kuder functionality
  - Access to the Scholarships functionality
  - Discuss how to navigate and find scholarships
  - Four - 30 minute virtual Financial Aid/Scholarship Coaching sessions with a HIFE Coach
    
    Explain varying types of financial aid and how they work
    
    Teach students and families how to maximize their user profile in national scholarship databases
    
    FAFSA/CSS Profile assistance and review
    
    Institutional financial aid forms
    
    Explain how to evaluate financial aid packages to best meet needs of student and family
    
    Provide guidance on educational loan options
Note on Scholarships & Financial Aid:

Since financial aid and all scholarships are managed and distributed by a grantor (such as the federal or state government, foundations, associations, corporate sponsors or colleges/universities) the Heartland Institute of Financial Education cannot guarantee that scholarships or grants will be awarded to any student.

However, our coaches will work diligently to provide each student the information outlined above to help maximize the student's opportunities for scholarships and other financial aid.
I acknowledge that I have read the above note about scholarships and financial aid and understand that HIFE does not guarantee that scholarships or other financial aid will be awarded to the student named in this application.

I Agree.
- Package 4: College Application & Essay Review
  - One-hour virtual Application/Essay Review Coaching session with a HIFE Coach
  - Review college applications (up to 2)
  - Review for common mistakes and missteps as well as provide suggestions to improve the application and maximize options.
  - Review college essays (up to 5 essays total). Our expert reviewers will provide feedback on the essay overall in addition to content, grammar and spelling.
  - 1 initial review per essay
  - 1 final review per essay
- Package 5: Post High School Planning
  - Kuder account
  - Helping the student transition into a college environment
  - Helping the student transfer to another school, if necessary
  - Working with students to find job experience through internships, part-time jobs
  - Guiding students in working with their career centers, building resumes, interviewing skills, etc.
  - Helping the student to work with different organizations and groups to start building a network
  - Four 30-minute sessions with a coach
This membership agreement constitutes the services provided and is designed to meet the college planning needs of each student through a combination of one or more of the specific services listed. All strategies and techniques are the property of the Heartland Institute of Financial Education and are intended for the sole use of the parties named on the face of this service agreement. HIFE is not in the business of rendering legal or tax advice. Strategies suggested are based on information provided by each student and family, which remains confidential.
HIFE Pledge
The primary role of the Heartland Institute of Financial Education is to assist the student and family with the career assessment and guidance. The success is dependent upon a 100% commitment of the student and family to implement.

The HIFE Pledge is reviewed regularly. In addition, the work effort contributed by the student is critical to the success of this program. The student confirms the pledge and the parent agrees to support the student in this endeavor.
Student/Family Pledge
THE HEARTLAND INSTITUTE OF FINANCIAL EDUCATION (HIFE)

SERVICE AGREEMENT INCLUDES THIS BASIC REQUIREMENT:

1) Each student must commit to doing their part by completing assigned paperwork and tasks.

Payment Information

The Heartland Institute of Financial Education will provide services based on the options chosen above for a one-time Non-Refundable fee of $649 for EACH PACKAGE CHOSEN*.

However, you can save by combining 2 or more packages (Options 1-4):

Regular Cost	Cost with Post High School (PHS) Planning Package*
1 package: $649	1 package + PHS Package = $998
2 packages: $1,249 (a savings of $49!)	2 packages + PHS Package = $1,598 (a savings of $49!)
3 packages: $1,849 (a savings of $98!)	3 packages: + PHS Package = $2,198 (a savings of $98!)
4 packages: $2,449 (a savings of $147!)	4 packages: + PHS Package = $2,798 (a savings of $147!)

*Please note that Option 5 can be combined with any/all options. However, it will always remain at the $349 cost and charged in addition to the regular package cost if chosen (see pricing in 2nd column above).

How do you wish to pay:*
If you wish to pay by credit card, please complete the remainder of the form and click "Submit".

Keep your browser open and you will be directed to the online payment page.
To pay by check, please complete the remainder of this form and click "Submit". You will be redirected to an online payment page. Feel free to close the payment website.

Choose the correct pricing option above based on the packages chosen.

You may send your payment to the following address:

Heartland Institute of Financial Education

8301 E. Prentice Ave. Ste. 312

Greenwood Village, CO 80111

Our team will assign a coach once payment has been received. Please be sure to pay for all packages selected or there may be a delay in assigning a coach.
HIFE Refund Policy
Thank you for your support of our mission! However, the Heartland Institute of Financial Education has a NO-REFUND policy. As such, all sales are FINAL.
HIFE Cancellation Policy
You can cancel services provided by the Heartland Institute of Financial Education (HIFE) at any time.

In order to cancel, written notice must be provided to the Heartland Institute. Emails are an acceptable form of cancellation and you can send your notice to accounting@hife-usa.org. Please allow 1-2 business days for your cancellation to be processed. However, any fees paid are non-refundable.
I agree to HIFE's Refund and Cancellation Policies*:*

I agree.
*Note: If you do not agree to the Refund and Cancellation policies, DO NOT SUBMIT THIS FORM or make payment on the payment website.
Payment Authorization
By signing this form below, I am providing my authorization to the Heartland Institute of Financial Education (HIFE) to charge my credit card on the payment site. This applies whether I am paying for myself or another party. The authorization also applies if I choose to make a pay by check.

I understand that if my credit card is declined, HIFE may, at its discretion, try to reprocess the charge again within the next 15 days.

I certify that I am an authorized user of the credit card used for payment on the payment site.

If you provide a check as payment, you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction.

When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day you make your payment, and you will not receive your check back from your financial institution.

I also certify that I have read, and agree to, the HIFE Refund and Cancellation Policies.
Payer's First and Last Name:
Payer's Email Address:*
*By signing your name below, you agree to the above stated requirements and confirm that you have read and understand this entire agreement and privacy policy; you also signify that you have read and agree to the terms of the refund and cancellation policies.
Payer's Signature* (please use your mouse, a finger or a stylus to sign below; if you are not able to sign, please try a different device):
Today's Date:

MonthDayYear
Date

Privacy Policy Notice
The Heartland Institute of Financial Education (HIFE) strongly believes in protecting the confidentiality and security of information we collect about you. This Notice refers to The Heartland Institute (HIFE) by using the terms “us”, “we” or “our”. This Notice describes our Privacy Policy and describes how we treat the (Information) we receive about you.

Why We Collect and How We Use Information: We collect and use Information for business purposes with respect to our business relationships involving you. These business purposes include processing transactions requested by you.

How We Collect Information: We get most Information directly from you. The Information that you give us when applying for our services generally provides the Information we need. If we need to verify Information or need additional Information, we may obtain Information from third parties.

How We Protect Information: We treat Information in a confidential manner. Our employees and associates acting on our behalf are required to protect the confidentiality of Information by complying with all confidentiality policies and applicable rules, regulations and statutes. Employees and associates may access Information only when there is an appropriate reason to do so, such as to administer or offer our products or services.

Information Disclosure: We may disclose any Information we believe is necessary for the conduct of our business, or where disclosure is required by law. For example, Information may be disclosed to others to enable them to provide business services for us, such as performing general administrative activities for us and assisting us in processing a transaction requested by you. Information may also be disclosed for audit or research purposes; or to law enforcement and regulatory agencies, for example, to help us prevent fraud. Information may be disclosed to others that are outside of HIFE, such as companies that process data for us or companies that provide general administrative services for us. We may make other disclosures of Information as permitted by law.

We do not make any other disclosures of Information to other companies who may want to sell their products or services to you. For example, we will not sell your name to a catalog company. In the unlikely event there were to be a change in this fundamental policy that would permit additional disclosures of your confidential Information, we will provide written notice to you and you will be given an opportunity to direct us as to whether such disclosure is permissible.

Access to and Correction of Information: Generally, upon your written request, we will make available information for your review. Information collected in connection with, or in anticipation of, any claim or legal proceeding will not be made available. If you notify us that the Information is incorrect, we will review it. If we agree, we will correct our records. If we do not agree, you may submit a short statement of dispute, which we will include in any further disclosure of Information.

Further Information: In addition to any other Privacy Policy Notice we may provide, a recently enacted federal law established new privacy standards and requires us to provide this summary of our Privacy Policy. You may have additional rights under other applicable laws. For additional information regarding our Privacy Policy, please write to us at 8301 E. Prentice Avenue, Suite 312, Greenwood Village, CO 80111.
NOTE: Before submitting this form, please be sure to verify all information (including packages selected).

You will not be able to make changes once you submit the form.
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