General Information Form

Course Information
Course/Program*
Academic Year*
Admission Date *

MonthDayYear
Month Enrolled*
Start Date *

MonthDayYear
Projected End Date *

MonthDayYear
Tuition Cost ($)*
Down payment ($)*
1st Payment Date *

MonthDayYear
Payment Method*
Student Documents*

Upload File (Please attach a copy of your ID & High School Certificate or GED)
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Date Signed *

MonthDayYear
Student Signature*

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School Administration Dept.

For official use only
Application Status
Student Code
Course Status
Completion Date

MonthDayYear
Certificate Earned
Certificate Issue Date

MonthDayYear
License Earned
License Issue Date

MonthDayYear
Employment Status Year 1
Employment Status Year 2
Employment Status Year 3
School Adminstrator
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Student tasks & Notes:

Tuition Payment Report

For official use only
Reason for Tuition discount:
Next Payment Date:

MonthDayYear
Payment 1 ($)
Payment 2 ($)
Payment 3 ($)
Payment 4 ($)
Payment 5 ($)
Payment 6 ($)
Payment Status:
Total Amount Paid
Total Balance
Upload Payment Receipts:

Upload Receipt Copies for: (Debit/Credit Card Payments, Checks, Money Orders & Cash Payments, etc.)
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Administrators Name:
1549 Old Bridge Rd. # 208, Woodbridge VA, 22192. Tel: 571-494-0032.
Should be Empty:

PHCT SCHOOL