Enrollment Form

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Contact Us:
(704) 319-5516

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

LNC EDUCATIONAL CENTER
7810 BALLANTYNE COMMONS PARKWAY, #300
CHARLOTTE, NORTH CAROLINA 28277
PHONE: 704-319-5516 / FAX:  704-319-5517 / EMAIL: information@lnccenter.com
 
LEGAL NURSE CONSULTANT CERTIFICATE PROGRAM APPLICATION

Full Name:
Date:
Your Address:
City:
State:
Zip Code:
Email Address:
Phone:
Nursing Licence:
Is your license in good standing w/Board of Nursing?
Nursing Specialty (or Area of Practice):
Which Program would you like to take?  
   
VIP Basic Program (Coupon Applied) ........................... $2450
Home Based Program (Coupon Applied) ......................... $2450
Home Based 4 Part Payment Program ........................... $2600
VIP Gold Program (Coupon Applied) ............................. $3400
VIP Platinum Program (Coupon Applied) ....................... $5400
City of Seminar:
Date of Seminar:
or
 
Home Based Program?:
Yes No

CANCELLATION POLICY: Full refund (minus $100 Registration Fee) with 7 or more days notice. IF CANCELLATION OCCURS 6 DAYS OR LESS, Prior to the classroom program, YOU MAY RECEIVE FULL TUITION CREDIT TOWARDS A FUTURE PROGRAM OFFERED, NO MONIES WILL BE REFUNDED.

All Home Based Programs requires a minimum $650 tuition payment plus shipping and handling prior receiving the LNC Program.

The LNC Center will allow all students FULL credit only applied towards another seminar, if student cancels one day before class begins. Home based students may also transfer to class training from Home Based, with small transfer fee to the classroom, if available.

 
I have read the above and agree to the terms. To the best of my knowledge all answers above are correct and true. Yes No
Digital Signature:
Did I purchase the programs online using Paypal? Yes No

(REMAINING BALANCE TO BE PAID WITHIN 1 YEAR)

Students in the 4 Part Payment Plan: Every 3 months, a $650 payment will be due and owing. However, students may opt to request to pay earlier than every 3 months. All LNC payments must be completed prior to sitting for the ASLNC Cert. Exam.

All applications and deposit checks must be mailed to: Legal Nurse Consulting Center, (address above) or credit card payment is available online from our website on the Online Payments page.

Please telephone us (704) 319-5516 if assistance is needed.

 
 
 
ENROLLMENT FORM EMAIL US HERE. Register for your classes here. Email Us