Course Enrollment Form

Ready to enhance your career? Let's get started today!

Personal Information

First Name

Last Name

Age

Street Address *

City

State

Country

Postal code

Phone *

Email *

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Academic Background

Note: This prerequisite is required for enrollment.

Have you completed Anatomy and Physiology 1 & 2? *

Yes

No

Date Completed *

You must provide a transcript to support all above requirements.

Aware of All Courses Recommended but Not Required, Up to Student Discretion:

1. Medical Terminology

2. Pathophysiology

Aware of Fees, Payment Plans, and Refunds

Class Fees: $1,700.00 for both classes (6 months duration)

*Classes can be taken individually (3 month duration)

All codes books, desired material, fees, and passing of the certification exam are not the

responsibility of LW Coding and Mentoring

LAST REFUNDS: January and July (last day/3rd week) of 2024

Payment Plans: ONLY for classes taken individually (3 month duration)

Class Fees: $850 for one class (3 month duration)

In order to register for a payment plan, 50% of your balance ($425) is due when registering.

Full balance must be paid before the first day of classes.

Aware of Grading System and Attendance Requirements

Grades

90- 100 (A)

80- 89 (B)

70- 79 (C)

60- 69 (D)

50- Below (F)

Class attendance is important:

To keep up with the process, students must have approval before missing classes.

Approval will be based on the urgency of the situation.

Student Responsibility

Students need to read coding Guidelines before each class.

Please complete this section before you submit the form.