Montessori Training

US Upper Elementary (9-12) Enrollment Form

Required fields marked with an asterisk (*)

Please Note:	When contacting us in any way (email, telephone or mail, etc.) please use the full name below at all times.
	Your diploma will be issued in the name provided below.

First Name:

Last Name:

Tuition receipt/diploma (please make the appropriate selection): *

Issue to student

Issue to school

I (the above mentioned) hereby make application for the North American Montessori Center’s Teacher Training Program. The Educational Institution’s full name offering this course is “Cornerstone Montessori Pre-School Ltd.”, d.b.a. North American Montessori Center "NAMC".

I understand the full tuition is $2,899.00 (US funds). This amount includes a $200.00 application processing fee. For a detailed description of total costs, including shipping, see the section titled “Payment Information” in this contract. Students have 4 months (for each of

the 3 sections) to submit their assignments by either mail or email. Payment can be made by VISA, MasterCard, school check, certified check (personal uncertified checks are NOT accepted), bank draft or international money order. All funds should be made payable to NAMC We will contact you as soon as we receive your payment and send your materials by UPS Courier. The diploma will be issued upon successful completion of the program by regular mail, unless otherwise specified.
Note: Tuition fees are subject to change, but not after initial enrollment.

SELECT WHERE TO SHIP, THEN COMPLETE ALL INFORMATION (Home, School, or Other Mailing Address). FOR SHIPPING INFORMATION, PLEASE PROVIDE PHYSICAL ADDRESS FOR COURIER DELIVERY. BOX NUMBERS ARE NOT ACCEPTED.

Ship to:*

Home

School

Other Address

	Home Address
Address line 1:
Address line 2:
City:
State:
Zip Code:
Tel #:
Fax#:
Other #:
Email:

School Address

Name:
Address:
City:
State:
Zip Code:
Tel#:
Fax #:
Email:
Director:

Type of School:

Montessori

Public

Private

Other:

Open all year for shipping?*

Yes

only required if school address is provided.

	Other Address
Address line 1:
Address line 2:
City:
State:
Zip Code:
Tel #:
Fax#:
Other#:
Email:

Teacher Training School Admission Prerequisite
Minimum education: Grade 12 or equivalent.

I verify that I meet this prerequisite. Documentation of proof of grade 12 completion (or equivalent) is not required at the time of enrollment. *

Please indicate your highest level of education*

I Accept

Per Component - Payment Information

a)	Tuition per component (all prices in US funds). . . . . . . . . . . . . . . . . . . .	$966.00
	The Tuition fee includes a cost of $149.00 for each curriculum manual.

b)	Shipping cost per section by UPS Courier express (approximately 2 business days). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	$50.00

	UPS delivers your materials to the address that you provide us. They do not require a signature, and will leave the package at the door. UPS does recommend that you provide an address where someone will be available to receive the package. UPS does not deliver to P.O. boxes. Throughout the program it is the student's responsibility to provide us with the correct address. There is a fee for redirected packages.

	All shipping is free when 2 or more people enroll together and shipment for each section is delivered to the same place, at the same time.

c)	Balance due for each component (1 of 3). . . . . . . . . . . . . . . . . . . . . . . . . . .	$1016.00

Payment Information: *
(all prices in US funds)

Amount being paid for each component.		$1016.00	($966 + $50 shipping)
~~2. Amount being paid for the entire course.~~		~~$2,999.00~~	~~($2,899 + $100 shipping)~~

For subsequent components (2 & 3), your credit card will be automatically processed when we receive your assignments, unless you provide alternative instructions in advance.

Payment Being Made by: *

VISA

MasterCard

Name of company issuing credit card *

Name as it appears on card:	Credit Card Number:	Expiry Month/Year:
*	*	/ *

Note: If you would prefer to enroll using one of our other convenient methods of payment, please print out the pdf form and mail it to our center.

The I.R.S. informs us that they will treat our receipt in the same manner that they would treat a receipt from a similar US Training Center.

Refund Policy

Refunds After the Program of Study Begins

If a student returns the first set of materials at their own expense, in their original condition to the Center within seven (7) days of their delivery, a full tuition refund will be returned.
If a student returns the second set of materials at their own expense, in their original condition to the Center within seven (7) days of their delivery, a full tuition second component refund will be returned.
There is no refund provision for the final course component.

I acknowledge that I have read and agree to the Refund Policy stated above. *

Personal Information Protection Act: In accordance with Part 4(10)(1)(a) of the Personal Information Protection Act, we hereby notify you that your name and personal identification information, the name of your program of study, and the amount of the tuition paid will be forwarded to the Private Career Training Institutions Agency (PCTIA) for the purpose of administering the Student Training Completion Fund. This information is collected by the PCTIA under section 26 of the Freedom of Information and Protection of Privacy Act. For more information about the collection, use and disclosure of your personal information, visit the Agency’s website: www.pctia.bc.ca.

I understand that this Training Program will be operated in conformity with the PCTIA Act, the regulations and the bylaws. I accept this registration of agreement and have a copy of it for my own safekeeping. *

If you are under 19 years of age, the signature of your parent or legal guardian must be appended as the responsible party of this agreement. Please print a copy of this form and fax it to 604.531.6698.

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