ENROLLMENT FORM

ENROLLMENT FORM

Please complete the enrollment application completely. Be sure to write "none" or "none applicable" instead of leaving the question unanswered. The Judgment Recovery Institute may limit enrollment in E-learn training programs offered through our institute to ensure sufficient time is available for each enrolled student allowing us to provide the highest quality of service. Completion of this form does not guarantee acceptance into any program. The institution will contact you within 24 hours or the next business day regarding the status of your acceptance into the Judgment Recovery Institute. There is no fee required to submit this enrollment form. Please do not send any money for tuition until you have been notified that your enrollment has been accepted. Once accepted, additional instructions will be submitted to you allowing you to complete the enrollment process by paying the necessary tuition due.
Name*

First NameLast Name
Company Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Email*
Phone Number*

Area CodePhone Number
Best Time to Call
Fax Number (optional)

Area CodePhone Number
Company website
JUDGMENT RECOVERY EXPERIENCE

Please answer the following questions completely. Be sure to write "none" or "non applicable" instead of leaving a question unanswered.
Have you ever purchased a written course on Judgment Recovery?*
Have you ever received any personal training?*
How long have you been in business?*
How many Assigned Judgments?*
How many Collected Judgments?*
Is this a*

Full time businessPart time business
How did you hear about Us?*
If you were referred directly to Us, by who?
Summary of Experienced (if any):
TRAINING PROGRAMS

New students are eligible to enroll into one of our four (4) Training programs below:
Select one (1):*

Independent FAST TRACK study - Includes 10 modules from audio lessons in the virtual campus and unlimited email support for 1 full year. $349E-Learn Basic - Includes 10 modules from audio lessons in the virtual campus, collaboration on up to 5 judgments, unlimited email support AND 1 full year of unlimited live coaching. $1,495E-Learn Advance Training - Includes 15 modules from audio lessons in the virtual campus, collaboration on up to 8 judgments, unlimited email support and 1 full year of unlimited live coaching. $1,995E-Learn Pro Training - Includes all 20 modules from audio lessons in the virtual campus, collaboration on up to 12 judgments, 5 page custom website & 1 year of hosting, unlimited email support and 1 full year of unlimited live coaching. $2,995
Patriot Grant (Grant Code - Patriot)

This grant is available for U.S. Military Veterans with a honorable discharge from the United States Army, Navy, Air Force, Marines or Coast Coast. The Patriot Grant will contribute 50% (up to $500) towards the tuition fee on any E-Learn Program AND provide you with lifetime access into the virtual campus.
I DO NOT qualify for this grantI DO qualify for this grant
PAYMENT TERMS

If accepted, payment for your selected Training Program is due within 72 hours. If payment is not paid in full within this time frame, we have the right to withdraw your enrollment. Or you may elect to enter into our simple Tuition Payment Plan Agreement (TPPA-10) which requires immediate payment of your first month tuition plus a one-time $50 enrollment fee for the 0% interest, monthly payment plan option. Remaining tuition balance must be paid within 9 months. Independent FAST TRACK Study program not eligible for TPPA-10.
Tuition to be paid*

In Full, upon acceptanceTuition Payment Plan Agreement (TPPA-10)
CANCELLATION / REFUND POLICY / MONEY-BACK GUARANTEE

The 24-hour evaluation period begins when the student has successfully registered their Login and Password allowing them access into the virtual campus environment. Please be sure to review the terms & conditions of our Money-Back Guarantee on our website at www.jrinstitute.com
**

I have read, understand and agree to the cancellation/refund / Money-Back Guarantee policy.
STUDENT ACCEPTANCE

My electronic signature below hereby acknowledges that I have read and understand the terms/conditions outlined in this enrollment form.
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ENROLLMENT FORM

JUDGMENT RECOVERY EXPERIENCE

TRAINING PROGRAMS

Patriot Grant (Grant Code - Patriot)

PAYMENT TERMS

CANCELLATION / REFUND POLICY / MONEY-BACK GUARANTEE

STUDENT ACCEPTANCE