Enrollment Agreement Sample

Terms of Payment of Tuition and Fees

Students have several payment options. Whichever they choose, the entire program must be paid in full in order to receive the Certification and CEUs. By signing the enrollment agreement, you are consenting to the policies and procedures of KTCI including the Student Code of Conduct.

Methods of Payment

A non-refundable deposit payment of $250 is due at the time of signing enrollment agreement to secure your seat with the remaining balance to be paid prior to graduation by a payment plan.

Students may negotiate, at the time of registration, a weekly, monthly, or quarterly payment plan. The balance may be paid in full at any time.

Payments may be made using a credit card, check, or money order.

Student Code of Conduct

 KTCI has a zero tolerance policy regarding its code of conduct. The topics we will be discussing in this program are controversial and you will feel uncomfortable at some point. Respect for persons, for example, requires that one act with respect, responsibility, and caring for all people. Any behavior that counteracts that imperative is subject to review under the Student Code of Conduct. At the same time, the procedures of the Student Code of Conduct review process require that persons under its purview be treated with respect.

Integrity not only requires that individuals behave truthfully, honestly, and fairly with each other and the institution; it also requires the Student Code of Conduct to be careful and honest in its evaluations.

The goals and process of KTCI’s Code of Conduct attempt to reflect our highest aspirations for working with this community. Once engaged, the student conduct system seeks, as a primary goal, to address the most basic expectations of student conduct through education and intervention.

Below is a list of actions that will be subject to disciplinary sanctions. The list is not all encompassing. Being under the influence of drugs and/or alcohol during KTCI events will not serve as an excuse if found in violation of the Student Code of Conduct. By signing the enrollment agreement, you are consenting to the policies and procedures of KTCI including the Student Code of Conduct. 

  1. Acts of dishonesty including, but not limited to, the following
  2. Cheating, plagiarism, or other forms of academic dishonesty
  3. Providing false information to any College official, faculty member, office, or hearing board acting in the performance of their duties
  4. Forgery, alteration, or misuse of any College document, record, or instrument of identification.
  5. Tampering with the election of any College-recognized student organization.
  6. A disruptive activity that causes the obstruction of teaching, learning, research, administration, conduct, or infringement upon the rights of others. Such activity includes, but is not limited to, behavior in a classroom or instructional program that interferes with the faculty member or presenter’s ability to conduct the class or program or the ability of others to profit from the class or program
  7. Harm to Persons: Actions which result in physical harm, have the potential for physically harming another person, which create conditions that pose a risk of physical harm to another, or which cause reasonable apprehension of physical harm are prohibited.
  8. Harassment: Conduct that creates or attempts to create an intimidating, hostile, or offensive environment for another person is prohibited. Such conduct includes, but is not limited to, action(s) or statement(s) that threaten harm, that intimidates a person, stalking voyeurism (or peeping), or any other form of unwanted contact.
  9. Sexual Misconduct: non-consensual sexual contact (or attempts to commit same), non-consensual sexual intercourse (or attempts to commit same), and/or sexual exploitation.
  10. Sexual Harassment: Unwelcome, gender-based verbal or physical conduct that:

√ Is sufficiently severe, pervasive, and objectively offensive.

√ Unreasonably interferes with, limits or deprives someone of the ability to participate in or benefit from the College’s educational program and/or activities.

√ Is based on power differentials (including quid pro quo), the creation of a hostile environment, or retaliation.

Cancellation and Institutional Refund Policy

A student may withdraw from the program prior to taking any classes, regardless of the number of days, and will be refunded all tuition paid within 30 days minus the $250 deposit. Withdrawal must be made in person or via Certified Mail. Should a student withdrawal during the program; a refund will be made based upon a $250 per class rate. Students are responsible for paying for each class taken plus clinical supervision fees.

I_______________________________________ have read and agree to the terms of the enrollment agreement.

Student Signature:

_______________________________________

Date:

_______________________________________

Print Name:

_______________________________________

Address:

_______________________________________

Phone Number:

_______________________________________

Email Address:

_______________________________________

License Number:

_______________________________________

Accepted by KTCI Representative:

_______________________________________