Enrollment Contract, Promissory Note:

This Promissory Note is entered by and between “Student” and Premier Nursing Academy, LLC.

Your Student File will be set up and completed at a rate of $350.00 from start to finish for anyone enrolling into our program. Your fees are waived upon successful completion of this class. Dropping after the first day of enrollment deprives another individual the opportunity to take our class and you will be billed for Student Set-Up fee and the cost of our class!

Your tuition is being sponsored by the facility who will be hiring you, “Company” to gain employment as a C.N.A. upon completion of our program. Company hereby agrees to pay “Student” class costs, $1000.00, in return for successful completion of class, taking state certification, obtaining licensure by the State of Indiana as a Certified Nursing Assistant, and becoming employed for no less than “6 months”. The Company is also requiring you to make a work commitment of 6 months for them to pay for your classes.

Your sponsoring facility, reserves the discretion to terminate a student’s clinical rotation; forfeiting future payments for student’s educational progress. If this we’re to happen, student would be responsible for remaining balance or withdrawing from C.N.A. class.

FOR VALUE RECEIVED, for each month Student completes at Company, Company will forgive class costs after 6 months of employment. Therefore, after six (6) months, Company will forgive the entire amount paid for tuition. However, if the Student leaves class throughout course of training or company, prior to completion of training or employment of (6) months, Student hereby agrees to reimburse Premier Nursing Placement for the remaining of the unforgiven a balance. Student must contact H/R or Director of Nursing the Friday after class concludes to start the employment process.

This Note shall be governed by and construed according to the laws of the State of Indiana, and any action or proceeding for enforcement or collection of sums due hereunder shall be brought in the County of Allen, City of Fort Wayne, Indiana.

Please initial the following highlighted policies and clarifications and submit this contract on your first day of class.

I understand that my tuition for this class is $1050.00 and the student set up fee is $350.00; total of $1350.00, which will be waived upon my successful completion of this class and employment of 6 months.

I understand that I am legally bound to my Enrollment Contract for the entire classroom and clinical portion of my education within the 6 month period.

I understand the reimbursement clause and if I drop I will be required to pay for my class in full; otherwise all payments will be sent to collections after 1 month. In the event my balance is sent to collections I agree to pay court costs, 8% interest, and reasonable attorney fees regardless if legal action is taken.


Digital Signature:

Date: