Medication Technician Training Registration Form

Medication Technician Training Registration Form

Full Name

Social Security

Date of Birth

Email Address

Gender

Male Female

Marital Status

Single Married Divorced Separated

Mailing Address

Primary Contact Number

Alternative Contact Number

FEES: Registration & Pretest: $50.00 (Non-Refundable) MBON Application fee: $20.00 Tuition: $250.00 Total: $320.00

Terms and Conditions

All applicants for the Medication Technician training program must strictly adhere to and attend classes for the required 20 hours of class work in order to successfully complete the training. Any student/applicant wishing to withdraw from the program and claim refund may do so prior to the start of the class, or as of day one of the class. Refund will be made according to the refund policy below. However, any applicant/student who does not attend classes and does not claim refund within one week of class start date shall not be entitled to refund.

Refund Policy

Less than 10% of Lesson - 100% refund
20-30% of Lesson (1st day of class) - 60% refund
More than 50% of Lesson (2 days of class) - No Refund
Non attendance more than 1 week after start of class - No Refund

Acknowledgement

I have read and understood the terms and conditions above regarding the Medication Technician Training Program. I accept and agree to the terms above and hereby affix my signature.

Full Name

Date

Accept Terms and Submit