CNA Training Registration Form

Thank you for your interest in our Training Program(s). Please read the following information carefully before you proceed.

Certified Nursing Assistant/Geriatric Nursing Assistant Program, 120 clock hours, Day Program: 4 Weeks, 30 hours per week, 6 hours per day (includes lunch), Monday through Friday and Evening Program: Lecture Monday – Friday   Five (5) days/week for four weeks & 5 hours/day Evening Section Variations: two (2) laboratory days will end an hour early and four (4) clinical days will be ½ hour longer.

Program Cost Breakdown

Item(s) Price(s)
Processing Fee

*CPR / First Aide training is also available at $100 upon student request.

Program(s) Terms & Conditions

Dominion Academy will provide students with textbooks (including a workbook). All these are included in your fee. Books will not be refunded even if a student acquires these from elsewhere. A non-refundable $50.00 Processing fee applies to $1,200.00. Tuition must be completed at most three days after the training program. All payments must be made in the form of a money order.

Program Completion

For a student to successfully complete the program, the student must achieve a grade of “B” or better in theory, a “P” Pass in laboratory and clinical, a minimum of 90% attendance rate, complete all payments, and then will receive an Achievement Award for program completion.

Dominion Academy acknowledges that job placement and salaries cannot be guaranteed to graduates who have met all graduation and financial requirements.  There is no promise or guarantee of placement.

Cancellation Policy

Dominion Academy reserves the right to cancel/postpone any program before the scheduled start date for which there is deficient registration.   If a program is canceled or rescheduled at a time during which the student cannot attend, tuition for that particular program will be refunded.  Tuition is the cost of instruction. Each of the programs cost different amounts. All tuition and fees are payable as outlined for their program of study. Students must pay the amount listed in the Dominion Academy payment plan.

The school does not have any other partial payment plan. Students with billing or payment questions or problems should contact Student Services Account representatives.

Dominion Academy will hold any student liable for any delinquent account until their indebtedness is removed. The school reserves the right to withhold transcripts and all other information regarding the record of any student who is in arrears in the payment of tuition, fees, or any charges. The student may be permanently dropped from the school for continued delinquency in paying debts to the school.

Refund Policy

Dominion Academy’s refund policy has been prepared according to the requirements of the Maryland Higher Education Commission. The student is responsible for the tuition and fees stated herein. With that understanding, the “refund” shall be defined as the return of money, cancellation of obligation, or otherwise extinction of the debt, and the following policy shall prevail.  The Processing fee is non-refundable after the seven-day cancellation period, as Maryland’s minimum refund policy requires. However, it can be transferred to another class within a (3) month period.  If a student wishes to cancel for any reason, intent to cancel should be in writing to Dominion Academy, Inc. before the start of classes. After classes begin, a student withdrawing from the school should inform the school of their intent. Under the following circumstances, all or part of tuition will be refunded:  If Dominion Academy closes or discontinues a course or program, Dominion Academy shall refund to each currently enrolled student monies paid by the student for tuition and fees and funds for which the student is liable for tuition and fees.

Dominion Academy shall refund all fees paid by a student if the student chooses not to enroll in or withdraw from a school within seven calendar days after signing a contract.  Dominion Academy will retain the Processing fee if the student decides not to enroll after the 7-day cancellation period but before the first day of instruction.  If, after the 7-day cancellation period expires, a student withdraws after instruction begins, refunds shall be based on the total contract price for the course or program and shall include all fees, except the processing, registration, or enrollment fee and any charges for materials, supplies, or books which have been purchased by, and are the property of, the student.

The minimum refund that Dominion Academy shall pay a student who withdraws or is terminated after 7-day cancellation period has expired and after instruction has begun, is as follows:

Proportion of total course/program taught by date of withdrawal Tuition Refund
Less than 10%
90% refund
10% up to but not including 20%
80% refund
20% up to but not including 30%
60% refund
30% up to but not including 40%
40% refund
40% up to 50%
20% refund
More than 50%
0% refund

A refund due to a student shall be based on the date of withdrawal or termination and paid within 30 days from the date of withdrawal or termination. The date of withdrawal or termination is the last date the student has attended.  In the case of an official leave of absence, if a student fails to return to Dominion Academy by the end of the leave of absence, a refund due a student shall be based on the date of withdrawal or termination and paid within 30 days of the scheduled last day of the leave of absence.  Failure to complete payment before withdrawal does not relieve you of financial liability.
This refund policy is based on the provisions of the Maryland Higher Education Commission.

Equal Opportunity

Dominion Academy, Inc. admits students regardless of sex, race, color, nationality, or ethnic origin. It accords all students the rights, privileges, programs, and activities generally accorded or made available to students at the school.  The school does not discriminate based on sex, race, color, national or ethnic origin, religion, or age in staff hiring, student admission, or administration of its policies and programs.

Student Grievance Resolution Procedure

It is the school’s objective to maintain good communication and to assure that the concerns of all members of the school community (students, staff, and instructors) are addressed fairly and promptly.  To accomplish this, the following process should be used in seeking resolution of a student’s concerns:

Step 1: Discuss with the course instructors (if appropriate, clinical, laboratory, and/or class.)
Step 2: Discuss this with the instructor, advisor, staff, or students involved.
Step 3: Discuss with the Program Director.
Step 4: A formal appeal to the Program Director.

In the fourth step, grievances must be submitted in writing to the Program Director within five (5) business days of the event.  The program director will appoint a school Grievance Committee to investigate the facts and make a recommendation for the case.  The School Grievance Committee will meet within ten (10) days of receipt of a written grievance.  The Program Director makes the final decision on all cases.


I understand that I will achieve Student Enrollment Status beginning the first day of class. I am confirming that I received information on course completion requirements. I have completed a personal interview at the school site and have had the opportunity to inspect the facilities and equipment. I have received a copy of the current school catalog. I also acknowledge that I have had enough opportunity to evaluate this information and ask questions of the school and its representatives. I have also been advised to keep a copy of all enrollment and financial obligations documents.

I have read and understand this Application for Enrollment and acknowledge receipt of an exact copy.  I acknowledge that no verbal statements have been made contrary to what is contained in this agreement.  I fully understand my rights and duties and agree to abide by them.  I understand that this agreement becomes a legally binding instrument upon the school’s written acceptance of the applicant, as evidenced by the applicant and school official’s signatures below, unless canceled pursuant to the abovementioned terms. This enrollment contract may be extended or modified only with the applicant’s and school officials’ written consent.

I understand that the tuition must be paid in full before the end of the program.  I understand that I am responsible for making monthly/weekly tuition payments.  I understand that I am responsible for my state certification fee.  I understand that I am responsible for purchasing the required books. I understand Dominion Academy will provide handouts, clinical instructions, a certificate of training, and an official transcript needed to apply for state certification.

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