OCBS Enrollment Form

Orange Bartending School 1819 E. Chapman Ave, Orange 92867
Source (Rep that assisted you):

Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
First Name
Last Name
E-mail:
example@example.com
Street Address:
Apt/Unit:
City:
State:
Zip Code:
DL#:
Phone Number:
DOB:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Alternate/Emergency Contact:

Please list an emergency contact name and phone number
Emergency Contact Name:
Emergency Phone Number
This Agreement is for the course/educational service: Bartender Training. All Course lessons and Final Tests must be completed for students to graduate and receive certification. [This includes a minimum of 40 logged hours.]
This contract grants the student 1 year membership with the Orange Bartending School.
Refund and Cancelation Policy:
National Bartenders Orange Bartending School has a strict no-refund policy for registration fees. Students are entitled to a full tuition reimbursement if said individual decides to cancel within the first three days of enrollment. If the student cancels after the initial three days but before 2 weeks following their enrollment date, they are entitled to one-third of the tuition as the refund amount. Any student who requests to cancel their contract after the two week period, or who has advanced beyond the completion of Lesson 3, is no longer entitled to a refund. If making payments but cancelling after the refund policy time period, any remaining balance not paid off will still be owed even after cancelling the agreement.
How will you be paying?
This section to be filled out by OCBS Staff
Deposit:
Balance Due:
# of Payments
These are the remaining payments after the initial Deposit

ELECTRONIC FUNDS TRANSFER (EFT)
AUTHORIZATION AGREEMENT
I hereby authorize National Bartenders School (NBS) of Orange to initiate credit entries for the withdrawal of #:
The payment is to be electronically withdrawn from my account for the following amounts and on the following dates:
Payment 1
Date of Payment 1

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Payment 2
Date of Payment 2

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Payment 3
Date of Payment 3

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Payment 4
Date of Payment 4

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
For a total of:
These payments are to be made until the balance is Paid-In-Full. Students will not be allowed to progress beyond lesson 3, 5, and 7 until the first, second and third payments, respectively, are collected.

NBS may assign its rights and obligations under this agreement to NBS' designated fee-for-service contractor. NBS may change its designated contractor at NBS' discretion.
Social:
The failure or decline of payment will result in the immediate submittal to the appropriate legal authorities and/or collections services and a permanent revocation of all lifetime Job Placement Assistance, lifetime refresher privileges, and bartending certification.
This authorization agreement is effective as of the signature date below and is to remain in full force and effect, or until NBS determines otherwise.

If my Financial Institution information changes, I agree to submit to NBS an updated EFT Authorization Agreement.
By signing below, I acknowledge that I have read, understand and agree to the terms and responsibilities stated above. I also acknowledge that I have read over the school refund and cancellation policy and agree to the terms discussed.
Student Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
OBS Authorized/Delegated Signature:
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Alternate/Emergency Contact: