Enrollment Application (Rev 2025)

Enrollment Application

Rev. E-2025
To apply for training courses at MBA USA, Inc, complete this enrollment application.

A copy of this application will be emailed to you upon submittal.

We will review your application and, upon approval, email you a separate Confirmation of Registration. You are not registered for your training course until we send you written confirmation.

Information requested on this application is for the purpose of identifying applicants in order to confirm their enrollment eligibility. This information is kept for the purpose of maintaining our school records and is not provided to other parties unless required by law.

Providing this information is voluntary, however not providing any requested information may affect the acceptance of your application.

MBA USA, Inc. is licensed by the Kentucky Commission on Proprietary Education
License no. R-KY-0222

Applicant Information

Please enter all requested information.
Name:

First NameMiddle NameLast NameSuffix
Home Address:

Street Address

Street Address Line 2

CityState

Zip CodeCountry
If you have an APO or FPO address:
Select United States for Country and enter your physical location in this box.
Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
This phone number is:
Email:
A copy of this form will be sent to the email address provided.
Date of Birth:

MonthDayYear
Date
Place of Birth:
Are you a U.S. Citizen
Have you ever been convicted of a felony?
Current Employer
Company Name
Work Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Years Employed Here
Previous Employer

If less than 5 years at current employer
Previous Employer Name
Previous Employer's Name
Previous Employer Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Years Employed Here
Character Reference
Name of Character Reference (no family members)

First NameLast Name
Address (City and State)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Reference Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Course Information

If you are applying for multiple consecutive courses, you may select them all on one application.
Government Security (GSA) Course you are applying for:
GSA Certified Safe & Vault Technician With GSA Approved Inspector
Because this course fills up quickly, we may allow you to choose to be put on a waiting list for certain dates. You may choose "Waiting list" here, or you may choose the next available class dates and ask to be on a waiting list for your preferred dates in the comment box near the end of this application.

Please be aware that being on a waiting list only does not give any preferential status for later class dates.

Being on a waiting list does not require any payment or deposit and is not an obligation on either of our parts.
Waiting List for GSA SVT
GSA Approved Container Inspection Course
GSA Container Identification
Sargent & Greenleaf Models 2937 & 2740B Lock Training
Kaba-Mas X-10 Factory Certification
Kaba-Mas CDX-10 Factory Certification
Drilling GSA Approved Containers and Locks
Physical Security Course you are applying for:
Government Physical Security Training
Commercial Physical Security Training
Professional Locksmithing
Advanced Locksmithing - Locksmith Specialties
Commercial Safe & Banking Class(es) you are applying for:
Mechanical Safe Locks
Safe Lock Manipulation
Electronic Safe Locks
Professional Safe Drilling
Safe Deposit Locks
Time Locks
Method of Payment

Your enrollment application will not be processed without one of the following:
- Recognized funding form for training* (SF182, or similar).
- Non-refundable deposit. The balance must be paid by the first day of class.
- Payment in full.
The amount of a deposit depends on the class and how many classes are being applied for.

• $500 non-refundable deposit for GSA Certified Safe and Vault Technician
• $100 per class non-refundable deposit for all other classes.

*Submitting an SF182 or similar form shows us that you are authorized to attend and that funding has been appropriated. No payment is necessary until the beginning of class.
Payment for this training will be by:
Standard Form 182 (SF 182) is the Federal Government's form to authorize an individual to attend training and appropriate funding. This simply shows us that you are authorized to attend and we'll get paid. State governments and some agencies within the Federal Government may use their own similar form.

If you are with a state government or other organization that uses some other sort of training authorization form or purchase order, contact us to make arrangements for submittal.

Please send your completed and approved SF182 or other funding approval form to education@mbausa.com

Your enrollment will not be confirmed until this is received. After submitting your form, any payments are not necessary until the first day of class.
An email invoice with a link to pay online will be sent to the email address you provided. If another individual will be paying, the email may be forwarded to them. Email invoices must be paid within 7 days.
Cancellation and Refund Policies

Should it be necessary for you to cancel your registration, the following policy shall apply:

If you paid a deposit with your application:
- No additional fees will be due. Deposits are non-refundable, but may be applied to a future class if cancelling at least 30 days before your registered training.
If you made payment in full:
- We will refund, at your request, the payment less an amount equal to a deposit that would otherwise have been collected. ($500 for the GSA Certified Safe and Vault Technician course, or $100 for each of all other classes).
- If canceling at least 30 days before the beginning of class, the withheld amount may be applied to a future class within one year.
- If cancelling less than 30 days before the beginning of class, the withheld amount is forfeit.
- Extenuating circumstances will be considered on a case-by-case basis.
Once class has begun, should it be necessary to cancel or dismiss a student, refunds will be based on the percentage of the course completed on the day of cancellation. When half of a training course is completed, no refunds will be made.

If not present the first day of class, and without written notice of cancellation to MBA USA, Inc., you forfeit all fees and deposits paid and will be billed for any unpaid balance.

MBA USA, Inc. reserves the right to cancel training classes as we determine necessary. Full refunds will be issued to students who have paid for cancelled training.

Any refunds will be made by MBA USA, Inc. within 30 days.

Commonwealth of Kentucky Consumers Right of Cancellation
- You may cancel this contract, without penalty or obligation, within 10 business days from the date you sign the contract.
- You may also cancel this contract if, upon doctor’s order, you cannot physically receive the services, or you may cancel the contract if the services cease to be offered as stated in the contract. If you cancel this contract for either of these reasons, the seller, MBA USA, Inc. may keep only a portion of the tuition or contract price.
- You may notify the seller, MBA USA, Inc., of your intent to cancel by giving written notice to: MBA USA, Inc., 200 Orchard Drive, Nicholasville, KY 40356-2357 or by electronic mail to education@mbausa.com.
- MBA USA, Inc. reserves the right to cancel a class due to insufficient enrollment. You will be notified and a full refund will be issued.
Filing a complaint with the Kentucky Commission on Proprietary Education To file a complaint with the Kentucky Commission on Proprietary Education, each person filing must submit a completed “Form to File a Complaint” (PE-24) to the Kentucky Commission on Proprietary Education by mail to Kentucky Commission on Proprietary Education, 500 Metro Street, 4th Floor, Frankfort, Kentucky 40601. This form can be found on the website at www.kcpe.ky.gov.

Student Protection Fund
KRS 165A.450 requires each school licensed by the Kentucky Commission on Proprietary Education to contribute to a Student Protection Fund which will be used to pay off debt incurred due to the closing of a school, discontinuance of a program, loss of license, or loss of accreditation by a school or program. To file a claim against the Student Protection Fund, each person filing must submit a completed “Form for Claims Against the Student Protection Fund”. This form can be found on the website, www.kcpe.ky.gov.
Application Submission

Information requested on this application is for the purpose of identifying applicants in order to confirm their enrollment eligibility. This information is kept for the purpose of maintaining our school records and is not provided to other parties unless required by law. Providing this information is voluntary, however not providing any requested information may affect the acceptance of your application.

Upon acceptance of this application, we will email you a separate enrollment confirmation.
Please confirm:
Signature
Type your full name. This constitutes your electronic signature.
Please confirm:
Comments
Waiting list for earlier class, special needs, questions, etc.
Date

MonthDayYear

AM/PM Option
Should be Empty:

Enrollment Application

Applicant Information

Course Information