Enrollment Contract

ENROLLMENT CONTRACT

Responsible Vendor
Please select an option below:*

I am an individual enrolling in the Responsible Vendor course.I am an employer paying for one or more employees to take the Responsible Vendor course.I am a sponsor or program administrator paying for one or more participants to take the Responsible Vendor course.
List the first and last names and last 4 digits of the person(s) you are paying for. Please list each person on a separate line.
Jane Doe, 1234
Name*

First NameLast Name
Name of company or program sponsoring employee/participant.
Social Security Number*
Last 4 digits of SSN
Date of Birth*

MonthDayYear
Date
Email Address*
example@example.com
Phone*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Identification Type:*

Driver's LicenseState IDPassport
State driver's license was issued in.
State ID was issued in.
State ID Number
Driver's License Number
Passport Number
Height*
Weight*
Goodwill Technical College and the student listed above enter into an agreement under which the student will pay tuition and fees as indicated below. The college will provide instruction in the Responsible Vendor curriculum as enrolled.

Program: Responsible Vendor (4 hours)

Tuition and Fees: $25
Select a training date:
Select a May 2024 Training Session
Select an June 2024 Training Session
Select a Training Session
REFUNDS
Cancellation prior to course start date: Tuition or fees collected before the start date of the course shall be refunded in full upon notice of withdrawal. Course withdrawals must be made online at gwtech.edu or submitted in writing via email to gtcadmissions@goodwillno.org.

Cancellation on or after course start date: I understand that if I withdraw from the course on or after the start date a refund will not be granted.
ACKNOWLEDGEMENTS AND SIGNATURES
- I agree to comply with the policies and procedures of Goodwill Technical College as outlined in the Goodwill Technical College catalog during my period of enrollment.
- I understand that if I have not paid my tuition and fees in full prior to the start date of the course I will not be permitted to participate in the course.
- I have read and understand the refund policy stated above.
- I understand that I must complete the course to take the examination.
Students Signature*

Clear
Date*

MonthDayYear
Date
Please select the checkbox below to add the course. If you are an employer or sponsor paying for more than one person, please use the quantity option to indicate the number of people you are paying for. Please make sure each person you are paying for is listed above.

Please note that Venmo and Pay Later are not options although listed. Payments can be made using PayPal Checkout which will allow you to pay with your PayPal account or by using a credit or debit card. If you have questions about the payment, please contact Kristel Shelton at (504) 889-5568 or email kshelton@goodwillno.org.
Add Course*
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Responsible Vendor CourseThis Louisiana Alcohol and Tobacco Control approved course is designed to ensure you meet the requirements to legally sell and serve alcohol and tobacco in Louisiana. Topics covered include state laws and regulations, validating identification, how alcohol affects the body, recognizing intoxication, and more.
$25.00 Quantity

Total

$0.00
IMPORTANT: Please note that Venmo and PayLater are not available at this time. Please use PayPal Checkout.
Pay with PayPal

Please click one of the PayPal options to complete payment and submit the form.
Should be Empty:

REFUNDS

ACKNOWLEDGEMENTS AND SIGNATURES