11. CareBridge Academy, LLC offers job placement assistance; it cannot guarantee employment following graduation from the Program.
12. Grievance/Complaint Procedure: Questions or concerns regarding the School’s satisfaction of the terms of the Enrollment Agreement may be directed to the School Director at (267) 448 0803. The School Director is located at the School (448 N. 10th St., Suite 400, Philadelphia, PA 19123).
CareBridge Academy, LLC is licensed by the Pennsylvania Department of Education, State Board of Private Licensed Schools. Any grievance not satisfactory resolved by persons listed above or by the school officials may be brought to the attention of the State Board of Private Licensed Schools Private Schools Pennsylvania Department of Education 607 South Drive, Floor 3E, Harrisburg, PA 17120.
13. Exclusion from Participation in Federal Health Care Programs notification: Providers who participate in the Medical Assistance (MA) Program must screen their employees and contractors, both individuals and entities, to determine if they have been excluded from participation in Medicare, Medicaid or any other federal health care program. By signing this agreement, attest to never being excluded from Medicare, Medicaid or any other federal health care program. It is my understanding that if I have been excluded from Medicare, Medicaid or any other federal health care program that I will not be able to enroll in the Nurse Aide Program.
14. Applicant Acknowledgement: I have read and understand all of the provisions of this Enrollment Agreement and accept all such provisions and have been given a copy of the Enrollment Agreement for my records. I have also received and read a copy of the School Catalog and understand and accept all of the terms of that Catalog. I acknowledge that no verbal promises or statements contrary to the terms of the Enrollment Agreement or the School Catalog have been made to me by any employee or representative of the School.
15. By signing this Enrollment Agreement, I acknowledge that my responses on the Enrollment Application are true and correct. I understand that the promotional material, School Catalog and any other information received by me from the School are not to be distributed or reproduced and are for my personal use only. I confirm that I am not acquiring information regarding any process or procedure of the School for a competitor nor am I representing an entity or individual other than myself. I understand that I will be held responsible for all costs involved in the replacement or repair of any of the School’s equipment or facilities if and when such damage is the result of my abuse or negligent treatment of such items or facilities.
STUDENT ACKNOWLEDGMENT OF ENROLLMENT AGREEMENT:
- I have read and understand this Enrollment Agreement Form
- I acknowledge receipt of an exact copy of this Enrollment Agreement Form
- I have read, understand, and been given a copy of the school catalog
- I have been advised to keep this document as well as copies of all financial documents.
- I understand this contract is legally binding after the school representative and I sign this document.
- The enrollment contract may be extended or modified only with the written consent of both parties signing below. (Applicant and School representative)
Intending to be legally bound hereby, the parties have signed this Enrollment Agreement on the dates below written.
A fully executed copy of this Enrollment Agreement will be given to the applicant upon acceptance and signature by CareBridge Academy, LLC.
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