Enrollment Form. Student Last Name* Student First Name* Student Middle Name* Student(s) Address Details* City/Town* State/Province*
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1 BUS Richmindale Page 1 of 10 For existing member adding another student: Member ID Name Enter the Student Information and Fee Details below, and leave the other information boxes blank. Important - Read Instructions Below! 1. Fields with * are required. Put N/A if not applicable. 2. Fill out all pages of this completely, and sign on the signature areas of each page to certify that the information you provided is true and correct. 3. Carefully read and understand the Terms and Conditions, and sign on the signature areas to accept. 4. Carefully review and discuss with your Course Consultant the Fee Schedule, and sign on the signature areas to agree and accept. 5. Submit this, with your signature on all pages, to your Course Consultant with the Reservation and/or Admission payment. 6. Get a copy of this and a Payment Receipt from your Course Consultant with the Richmindale ID and your Course Consultant s signature in the box at the right-hand side, and most importantly, Richmindale Manager s approval signature. 7. Note instructions from your Course Consultant for the next steps. Official use only Richmindale Member ID Enrollment Date Payment Received by Course Consultant Signature over printed name and ID of Course Consultant A. STUDENT(S) INFORMATION Student Last Name* Student First Name* Student Middle Name* Student(s) Address Details* City/Town* State/Province* Country* Nationality* Religion* Phone Number (Primary)* Birth Date* Address* Phone Number (Secondary)* Gender* Level* Male Female
2 BUS Richmindale Page 2 of 10 B. FATHER INFORMATION (Put N/A on all fields below if not applicable) Last Name* First Name* Middle Name* Full Address* Nationality* Address* Phone Number* C. MOTHER INFORMATION (Put N/A on all fields below if not applicable) Last Name* First Name* Middle Name* Full Address* Nationality* Address* Phone Number* D. MEMBER INFORMATION Mark this circle if the Student is the member. Put N/A on all fields below. Mark this circle if the Father is the member. Put N/A on all fields below. Mark this circle if the Mother is the member. Put N/A on all fields below. Mark this circle if the Member is a different person. Fill out all fields below. Last Name* First Name* Middle Name* Full Address* Address* Provide details on your relationship with the Student*
3 BUS Richmindale Page 3 of 10 E. REFERRAL INFORMATION Referred By (Member ID and Full Name)* F. ADMISSION APPROVAL (Official use only) Comments Approved for Admission by Richmindale Manager Signature over printed name and ID of Richmindale Manager G. REQUIREMENTS Submit the following requirements on or before the classes start: 1. Original Transcript of Records from the Student s previous school (applicable to Grade 2 or above). 2. Certified True Copy of Birth Certificate. 3. Copy of Immunization Card (Baby Book) or Health Records. Attach 2 x 2 Photo Here. 4. One (1) Photo (2 x 2 with white background).
4 BUS Richmindale Page 4 of 10 H. TERMS AND CONDITIONS 1. Agreement Please read these terms and conditions carefully as they shall form part of the contract between Richmindale and the member. It is important that the member makes sure that he/she has read and understood all of these terms and conditions. By signing this document, the member confirms that he/she has read, understood, agreed and accepted these terms and conditions, and that he/she, and the student if not him/her, agreed to abide by the processes, policies and procedures of the school. These terms and conditions apply regardless of changes made to the student s study program. 2. Definitions 2.1 Richmindale or School - Richmindale University, Richmindale International School, or its affiliates. 2.2 Student - the person who has been admitted and enrolled at Richmindale. 2.3 Member - the person responsible for the payment of school fees of the student. The member can be the student, a parent of the student, or a designated agent of the student as specifically mentioned as the Member in this document. If the student did not specify the member in this form, Richmindale will consider the student as the member. 2.4 Parent - the person who has parental responsibility of the student by law. 2.5 Guardian - the parent, or any person who has been appointed by the parent or by law to take care of the student who is considered minor at the date when these terms and conditions are agreed. 2.6 Designated Agent - the person or organization that the student (if not dependent), parent, or guardian of the student, has entered into a contract for the provision of services relating to educational choices advisory for the student. 2.7 Sponsor - the person or organization that pays for or contributes to the school fees of the student. For the sake of clarity, even if a sponsor pays for or contributes to the school fees of the student, Richmindale still considers the registered member as the person responsible for the payment of school fees of the student as defined in section 2.3 of this document. 2.8 School Administration - the regulatory body of Richmindale led by the school s President at the headquarters level. A Branch Manager has an approval authority at the branch where he/she is managing; however, the President can override the Branch Manager. 2.9 Program - a program of study is a logical set of different courses and topics combined together, organized and sequenced in a logical manner to provide the required competency when delivered to a student from which it is designed Course - a set of topics organized and sequenced in a logical manner; courses define the path to complete a program. 3. Admission 3.1 Admission is part of enrollment. The application for enrollment can be done in different ways. Contact any of our Course Consultants for more details.
5 BUS Richmindale Page 5 of In order for a student to be enrolled in Richmindale, the (this form) must be completed and signed by the member, successfully submitted to Richmindale, and approved by the Richmindale Manager. The must have the required documents attached, or if not, the approving Richmindale Manager must have agreed with the member to submit the required documents on the agreed date, and document the agreement in the Comments box under Section F. Admission Approval of this document. 3.3 A copy of the approved will be handed over to the member after receipt of the agreed fee payment. 4. Provision of Study Programs, Facilities, Equipment and Materials 4.1 Richmindale reserves the right to cancel a study program or a course within a program that has less than the minimum number of students. The minimum number of students is ten (10). 4.2 Richmindale reserves the right to withdraw from offer, a program or a course within a program, at any time, giving reasonable notice wherever possible, and will provide a suitable alternative program or subject wherever possible. 4.3 Richmindale will provide to the students all materials required for the program. Since all Richmindale programs utilize digital technology, most materials will be in a digital format, unless specified in the program requirements. Laptops may be provided by Richmindale to the student for free, or for a fee on a case-by-case basis. 4.4 Richmindale reserves the right to charge a member for loss or damage of Richmindale properties, and/or loss or damage of Richmindale-provided equipment, equivalent to the amount specified in Section 19 Property Loss or Damage Fees of this document. 4.5 Richmindale programs are offered via distance learning, classroom learning, or a hybrid of distance learning and classroom learning. For students enrolled in the hybrid learning classes, they will have specific on-premise and off-premise learning schedules organized by the school. Any student who prefers to be on-premise majority of the time shall seek prior approval from the school administration for schedule adjustments. Richmindale reserves the right to reject any requests for change of schedule. During off-premise learning, students can communicate to their appointed adviser, through or video-conference if they have internet connection available at the location, or phone call provided to them by Richmindale. 4.6 Richmindale reserves the right to alter the content, nature and venue of a program or a course within a program at any time. 5. Fees 5.1 All fees related to the student's study program are detailed in Section I. Fee Schedule of this document. Richmindale regrets that it cannot extend credit to the members. All fees must be paid on time, in cash or credit card, as agreed in the Fee Schedule section. All payment charges, if applicable, shall be paid by the member. Sponsors can directly pay the school fees of the student whom they are sponsoring on behalf of the member, provided the member mentions the name of the sponsors in the Comments box in Section F. Admission Approval of this form. It is the member s responsibility to coordinate payments of school fees of the student with the sponsors to avoid unnecessary work. 5.2 Invoiced expenses for agreed additional services during the study period of the student that are not included in this agreement will be due for payment by the member within fourteen (14) days from the invoice date.
6 BUS Richmindale Page 6 of Debit and Credit card payments are subject to a 4% surcharge to cover debit or credit card processing fees. 5.4 Richmindale reserves the right to increase the fees at any time. If the member availed the Tuition Lock- In promotion, the member will not be affected by the increase during the lock-in period defined in Section 16. Tuition Fee Terms of this document. 5.5 Richmindale reserves the right to alter the method of payment if deemed necessary at any time. In cases where it is reasonably impossible for the member to pay the fees through the new method of payment, the member must pay the fees in cash. 5.6 Richmindale may offer referral fees to its members. If offered, the referral fees shall be defined in Section 18. Referral Commission Fees of this document, and agreed by Richmindale and the member. Referral fees are paid in proportion to the actual payments made by the referred members. 6. Attendance 6.1 Attendance of students is monitored though the Richmindale Learning Application System during offpremise sessions. During on-premise sessions, attendance is monitored and recorded by the student adviser or representative thereof. Students are required to maintain appropriate level of attendance as defined by the education regulating body based on the country selected for student credentials. Richmindale reserves the right to evaluate and expel students due to poor attendance. 7. Cancellation and Withdrawal 7.1 The acceptance of a student s enrollment in Richmindale means that a place has been reserved for the student in the school. In cases where that place is canceled by the member, the following shall apply: Before the program starts: All advance tuition fees paid by the member will be refunded, except the admission fee to cover administration and miscellaneous expenses On or after the program starts: No refund. 7.2 Written cancellation request must be given to and received by the Richmindale Manager. Failure to provide written cancellation request will apply section 7.1 of this document. 8. Medical Provision 8.1 Richmindale does not provide or insure for the provision of medical or dental treatment of students whilst in school premises. It is important that the school is made aware of any welfare or medical conditions or disabilities of the student. If a student arrives in the school with a pre-existing condition which was not declared at the time of application for enrollment, Richmindale reserves the right to either ask the student to leave the school, or send the student for private medical or psychological treatment or tests, which will be at the member s expense. 9. Publicity 9.1 By signing this document, the member consents to the reasonable use of the student s details and academic achievements, including images or recordings of the student howsoever made. 9.2 Richmindale reserves the right to alter the details of any published information at any time.
7 BUS Richmindale Page 7 of Data Protection 10.1 Any information provided to the school may be held on a computer and shall be used by the school in accordance with its data protection registration and the data protection principles. 11. Grounds for Exclusion 11.1 The student must abide by the school's rules. Richmindale reserves the right to require a student s withdrawal including immediate withdrawal from a program, or part of a program, for a serious or aggravated disciplinary or behavioral matter including continued or repeated misconduct, or if it is considered by the school administration that such a withdrawal is in the best interests of the student or the study group In the event of a student s temporary or permanent exclusion from a program, or expulsion from the school, no refund of fees for the current academic year or deposit will be made If in the reasonable opinion of the school administration, the student has not satisfactorily attended lessons or has achieved below 80% actual attendance, or has failed to attain reasonable performance targets, the school may not allow the student to continue with the program for which they are enrolled. In such circumstances, the student may be offered suitable alternative programs or asked to withdraw from the school. In the event of a student being withdrawn, no refund of the fees or deposit will be made Any student found to have misled the school as to their qualifications, medical or psychological history, learning difficulties, or suitability for entry will be subject to expulsion from the school without recourse to refund of tuition fees already paid. If an alternative program is found more suitable, a student may be counseled on to such program Richmindale considers drug and alcohol abuse as major offenses subject to permanent exclusion. Richmindale reserves the right to investigate students found under such circumstances. 12. Penalties and Fines 12.1 The student is liable for any breakages, loss or damage caused by the student to the premises in which the student is being taught. Richmindale reserves the right to charge the equivalent amount of the damage to the member Richmindale may impose a reasonable penalty or fine to the member for other forms of student misconduct such as contravening health & safety regulations or infringing school policy. 13. Liability 13.1 Richmindale does not accept responsibility or liability whatsoever, including liability through the acts, omissions or negligence of its employees, agents or assignees for the student s and/or member s personal property. The student and member are advised to take out personal insurance to cover any loss or damage to personal property which may occur while they are in the school premises Richmindale shall not be liable for either death or personal injury suffered by any student. The member agrees to notify the school of special dietary needs, allergies or other medical conditions of the student where special arrangements have to be made. The member also agrees that the school may administer any non-prescription medication or first aid as is deemed appropriate and to seek medical, dental or optical treatment when required.
8 BUS Richmindale Page 8 of 10 I. FEE SCHEDULE 14. Currency 14.1 Currency used: 15. Tuition Fees per Student Ref Description Amount Comments 15.1 Total Tuition Fee 15.2 Less: Financial Aid 15.3 Less: Discount 15.4 Net Tuition Fee 16. Tuition Fee Terms Ref Description 16.1 Tuition Fee Lock-In Period 16.2 Tuition Fee Lock-In Amount 16.3 Tuition Fee Notes (Richmindale manager approval signature over printed name)
9 BUS Richmindale Page 9 of Payment Schedule Ref Description Amount Comments 17.1 Reservation/Admission Fee 17.2 Payment Payment Payment Payment Payment Payment Payment Payment Payment Payment Referral Commission Fees Ref Description Amount Comments 18.1 Referral Commission per Student 19. Property Loss or Damage Fees Ref Description Amount Comments 19.1 Property Loss or Damage Fees To be determined 20. Richmindale Approval of Fees I, the Manager of Richmindale Branch, hereby confirm that I agree and approve the fee schedule detailed in this document for the registered member. (Richmindale manager approval signature over printed name)
10 BUS Richmindale Page 10 of 10 J. ACCEPTANCE I, the registered member, hereby affixed my signature to certify that the information that I provided in this document is true and correct to the best of my knowledge. I undertake to inform the school immediately for any changes in the particulars relating to the information and study of the student, or of my wish to cancel it. I confirm that I understand, agree and accept all fees detailed in this document. I accept that, as the registered member, and as defined in section 2.3 of this document, I am fully responsible for the payment of the agreed school fees of each student mentioned in this document. I further confirm that I understand, agree and accept the terms and conditions set out in this document.
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