Classic Home Care Licensure Training Course
Applicant Registration Form (Please DO NOT submit Multiple Applications )
Agency Name or Applicant Name
Agency or School Owner (REQUIRED ATTENDANCE)
First Name
Last Name
Agency or School Director (Must Meet Minimum Qualifications)
First Name
Last Name
Franchise Company
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Please add the First and Last names of anyone else besides yourself who will be attending this course. Add N/A if you will be the only one.
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Email
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Address
Street Address
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State / Province
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Phone Number
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Desired Class Date
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Day
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****Please see website for available class dates ****(THURSDAYS / FRIDAYS ONLY)
We require a deposit of 50% in order to secure your spot in class. Would you prefer to pay via:
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Home Care Provider Training Course: $400
$
400.00
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HR & Client Forms $500
$
500.00
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Initial Licensure Policies
$
898.00
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Medicaid Training Manual $300
$
300.00
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Nursing Skilled Services Policies
$
1,448.00
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Consulting Services: $200/hr
$
200.00
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Marketing (Website/Logo Design & Branding) Call for Quote
$
Free
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Bundle & Save (Licensure Class & In-Home Aide Procedures)
$
1,150.00
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Total Start Up Package (See Website for Details) $2800
$
2,800.00
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Employee Handbook
$
250.00
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Family Home Polices
$
898.00
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Consulting opening your own CNA School
$
3,000.00
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Consulting opening your own Proprietary School
$
5,000.00
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Franchise Companies Prices for Polices start at $2000-$3500 call for special bundles policy prices.
$
Free
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Respiratory Therapy
$
898.00
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Physical Therapy
$
898.00
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Occupational Therapy
$
898.00
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Speech Therapy
$
898.00
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Medical Social Work
$
898.00
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Durable Medical Equipment
$
898.00
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Nursing Pool
$
1,448.00
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Nursing Services
$
1,448.00
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Infusion Nursing
$
1,448.00
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Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
I understand that this class is offered for educational purposes only and does not guarantee that the attendee will be granted a license by NC DHSR. Neither Classic Services, nor any of it's officers, directors, employees, or affiliates shall be liable for any direct, indirect, special, consequential, punitive, exemplary and/or incidental damages of any kind whatsoever (including but not limited to: loss of profits or attorney's fees) in any way due to, resulting from, or arising in connection with the Registrants acquisition or use of the Materials, or from the Registrants reliance on any information provided. This limitation applies to all causes of action in the aggregate including but not limited to: breach of contract, breach of warranty, negligence, strict liability, misrepresentation, and any other tort. Refunds are not offered; you may however reschedule to a different training date.
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